Diabetic retinopathy: symptoms, classification, causes and treatment

One of the most common complications of diabetes mellitus is the involvement of white organs, including the eyes, producing a condition known as diabetic retinopathy. This appears when the vessels of the retina have deteriorated, these can dilate and cause the escape of fluids, such as blood, plasma, or lipids, leaving part of the retina without circulation.

Diabetic retinopathy is considered one of the leading causes of blindness at productive age. If this condition is detected early, it can be prevented, so knowing its causes and symptoms is essential. In this FastlyHealarticle, we will talk about diabetic retinopathy, the causes, symptoms, classification, and the appropriate treatment.

Causes of diabetic retinopathy

Diabetic retinopathy is a frequent complication of poorly controlled diabetes mellitus. It is considered the most frequent cause of blindness at productive age.

It generally occurs when the increase in the level of glucose or sugar in the blood damages the retina’s blood vessels. It is known that good vision requires a healthy retina. In this way, any condition in it directly affects visual capacity. At first, this condition may not be fully manifest, but the damage is usually irreversible when it progresses.

The altered blood vessels dilate, generating an escape of fluids, such as plasma, blood, and lipids, leaving the retina without optimal circulation. All this leads to a severe decrease in vision and, if not appropriately treated, leads to blindness.

Diabetes mellitus, in addition to having complications related to vision, can affect other white or sensitive organs, such as the kidneys, nerves, and heart, hence the importance of controlling diabetes mellitus, which is more than a disease is a condition of life.

According to the Baviera clinic, diabetic retinopathy affects 98% of patients with type 1 or insulin-dependent diabetes mellitus and 60% of those with type 2 or non-insulin-dependent diabetes mellitus.

It is also associated with the presence of risk factors such as:

1. Poor metabolic control.
2. Arterial hypertension.
3. Renal disease.
4. Pregnancy.
5. Tobacco use.
6. High cholesterol.
7. African American, Hispanic, or Native American race.

Diabetic retinopathy: classification

Different findings medically serve to define the classification of diabetic retinopathy. The international council of ophthalmology [1] classifies it as follows:

1. Mild non-proliferative diabetic retinopathy: where a new vascularization has not yet developed to compensate for the damage done to the retinal vessels. It may have other characteristic lesions of diabetic retinopathy such as microaneurysms, the first lesson that can be seen ophthalmologically and which are considered indicators of the progression of the disease. Microaneurysms are small areas of inflammation that look like blisters in the retina’s tiny blood vessels.
2. Moderate non-proliferative retinopathy: other signs are observed, in addition to microaneurysms, such as spot hemorrhages, exudates, cotton wool spots.
3. Severe nonproliferative diabetic retinopathy: the characteristics of moderate nonproliferative diabetic retinopathy are presented, plus some of these characteristics: intraretinal hemorrhage, defined venous lines, intraretinal microvascular abnormalities, or no signs of proliferative retinopathy.
4. Proliferative retinopathy is characterized by non-proliferative diabetic retinopathy plus one of these two characteristics: neovascularization or preretinal vitreous hemorrhage. This is the most advanced stage of diabetic retinopathy.
5. Diabetic macular edema: This complication is evaluated separately in each of the stages of diabetic retinopathy and follows an independent course.

Regarding diabetic macular edema, there are specific ophthalmological findings:

• No diabetic macular edema: there is no thickening of the retina or hard exudates in the macula.
• Diabetic macular edema without central involvement: there is a thickening of the retina in the macula without compromising the area.
• Diabetic macular edema with central involvement: there is the thickening of the macula’s retina with the area’s participation.

Diabetic retinopathy: symptoms

The most common symptoms of diabetic retinopathy are:

• Slight and progressive decrease in vision.
• Blurry vision.
• Blank or dark areas in vision.
• Poor night vision.
• Dark or muted colors.
• Acute intraocular bleeding: is one of the main manifestations of diabetic retinopathy.

Sometimes diabetic retinopathy is present and does not reflect any symptoms even in very advanced stages.

Diabetic retinopathy: treatment

It depends on the patient’s clinical manifestation, and the specialist will indicate one treatment or another. In some cases, only constant assessment of ocular status will be required.

The patient must have strict control of blood glucose values and adequate control of blood pressure if retinopathy is due to hypertension.

The laser photocoagulation in one or more sessions, once it is determined the state of the retina’s blood vessels through a procedure known as fluorescence angiography. Applying a laser is another possible method to treat diabetic retinopathy, which is performed on the abnormal vessels of the retina to reduce edema and prevent the progression of the disease to the most severe stages.

In severe cases, in intraocular hemorrhage and retinal detachment, it is necessary to apply techniques such as intraocular microsurgery, which is medically known as vitrectomy. This procedure is done under local anesthesia.

Another treatment for diabetic retinopathy is the injection of drugs into the eye: the ophthalmologist may order the administration of drugs directly into the eye’s vitreous humor. These drugs are inhibitors of vascular endothelial growth factors and help stop the growth of new blood vessels.

How to prevent diabetic retinopathy?

The best way to prevent the appearance of this complication of diabetes mellitus is:

1. Maintain the glucose or sugar concentration in the blood at optimal levels.
2. Eat a healthy diet.
3. Include physical activity as a daily routine.
4. Perform the glycated hemoglobin test every three months to determine the glucose concentration in the blood during that time.
5. Maintain blood pressure at adequate levels.
6. Keep your cholesterol within normal limits.
7. Avoid smoking cigarettes.

Following these recommendations, once diabetes mellitus is diagnosed, regardless of its type, will allow you to avoid complications related to this condition, including diabetic retinopathy.

This article is merely informative. At FastlyHeal .com, we do not have the power to prescribe medical treatments or make any diagnosis. We invite you to see a doctor if you present any condition or discomfort.

If you want to read more articles similar to Diabetic retinopathy: symptoms, classification, causes, and treatment, we recommend entering our Endocrine System category.

Alivia Nyhan

I am a Surgeon with a diploma in comprehensive ultrasound and surgical care residency, an area I am specializing in. During the exercise of my profession, I have realized the need for patients to know the diseases they suffer, and I can tell you that a large part of their complications is due to a lack of information. Being a health web writer allows me to transmit my experience, without borders, to all those readers eager for knowledge, educate them in the prevention of diseases and promote a healthy lifestyle.