Microaneurysms are tiny bulges in the small blood vessels of a person’s retina. They are an early symptom of diabetic retinopathy that only doctors can detect. People with undetected diabetic retinopathy are at risk of vision loss over time.

Diabetic retinopathy (DR) is an eye condition that affects people living with diabetes. DR can cause microaneurysms in the blood vessels of a person’s retina. The retina is the light-sensitive area at the back of the eye.

This damage to the retina can result in vision loss and blindness if left untreated over time. One early symptom of DR is microaneurysms. However, doctors can only detect microaneurysms during a dilated eye exam. People with DR may not notice or have any other DR symptoms.

This article examines the link between microaneurysms and diabetic retinopathy.

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In the early stages of DR, blood vessels in a person’s retina weaken. Tiny bulges, or microaneurysms, can develop in weakened blood vessels. These microaneurysms may leak fluid or blood into a person’s retina. They can also develop in a part of their retina called the macula.

A person’s macula is part of their retina responsible for sharp, detailed central vision. If microaneurysms develop in a person’s macula, they can cause it to swell. This swelling may distort their vision.

Microaneurysms occur in DR due to the effects diabetes causes. People with diabetes may experience hyperglycemia, or high blood sugar levels, which can affect blood vessels throughout their body over time.

High blood sugar levels can damage the delicate blood vessels in the retina and also affect blood flow through them. This damage can lead to blood vessels in the retina developing microaneurysms.

DR progresses through different stages, and doctors typically classify it into two main types.

The early stages of DR are known as nonproliferative diabetic retinopathy (NPDR). If people with early DR develop microaneurysms in their macula, they may notice changes in their vision. These changes can include difficulty reading and seeing distant objects. These symptoms may come and go. People with early DR may not notice them.

If a person’s macula does not yet have microaneurysms, they will typically not experience any symptoms of early DR. However, doctors can detect DR at this stage during dilated eye exams.

Doctors call the advanced stage proliferative diabetic retinopathy (PDR). In this stage, a person’s retina grows new blood vessels to replace the affected ones. These new blood vessels are fragile and may leak blood or fluids into a person’s vitreous. A person’s vitreous is the gel that fills the back of the eye. It provides nutrients to a person’s eye and helps it keep its shape.

Click here to learn more about NPDR and PDR.

People with PDR may experience symptoms, including:

  • blurred vision
  • vision that sometimes changes from blurry to clear
  • eye floaters, or seeing spots or dark shapes across their vision
  • difficulty seeing colors
  • empty or dark areas in their vision
  • difficulty seeing at night, or night blindness
  • seeing colors as faded or washed out

People with DR usually have symptoms in both eyes.

Doctors diagnose a person’s DR using:

  • Dilated eye exams: Doctors give people eye drops to widen the pupils of their eyes when performing dilated eye exams. They then use special instruments, such as a fundoscope, to check for any signs of DR, including microaneurysms. These bulges may appear as small red dots across a retina.
  • Fluorescein angiography: When using fluorescein angiography, doctors inject fluorescent dye into a person’s bloodstream. The dye highlights blood vessels at the back of the person’s eye. This lets doctors check for the signs of DR using a special camera.
  • Optical coherence tomography (OCT): Doctors use OCT machines to scan a person’s retina. The machine provides a detailed scan of their retina using light waves. This helps doctors check how much swelling a person’s retina or macula has.

Treatment options for DR include surgery and medication. Surgical treatment options for DR include:

  • Laser therapy: Doctors can use laser therapy to stop a person’s DR progression. Doctors use lasers to seal off leaking blood vessels or remove affected ones. Other names for laser therapy are laser photocoagulation or scatter laser surgery.
  • Vitrectomy: Vitrectomy involves doctors surgically removing some or all of a person’s affected vitreous to improve their sight. People with advanced DR may have scar tissue or blood in their vitreous, affecting their vision.
  • Retinal reattachment: DR can cause scars to develop on a person’s retina that eventually cause it to detach. People with detached retinas have vision loss or other problems with their sight. Doctors can surgically reattach their retina, which may help improve their sight.

Medication-based treatment options for DR involve anti-vascular endothelial growth factor (anti-VEGF) inhibitors. A doctor injects these drugs into the eye. They can help slow down abnormal growth of blood vessels in a person’s retina. This may help slow or stop vision loss caused by a person’s affected blood vessels.

Currently, there is no cure for DR. However, doctors can treat DR to help stop further vision loss, but they cannot typically reverse any effects DR causes.

People with diabetic retinopathy can develop microaneurysms, or bulges, in the blood vessels of their retina. Over time, these microaneurysms can result in vision loss or blindness.

In the early stages of DR, microaneurysms may not cause any symptoms. Doctors can detect microaneurysms during eye exams or checks. As such, it is vital to attend regular eye screenings. This can allow a doctor to detect signs of DR early and initiate treatment if necessary.