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                                                 Diabetes

Diabetic retinopathy is a complication of diabetes that affects the retina. It can cause the tiny blood vessels in the retina to leak or become blocked. The former can lead to swelling of the retina. The latter can result in the growth of new vessels that may bleed and fill the eye with blood. Or it may pull the retina away from the sclera or wall of the eye. Each can cause loss of vision. Retinopathy is usually classified according to its severity, which may differ in both eyes.

Background retinopathy
This is the earliest stage in the development of retinopathy, but is uncommon in patients who have had diabetes for less than 8-10 years. At this stage in the development of retinopathy, vision is normal and there is no threat to sight. However, the presence of diabetic changes of haemorrhage, abnormal blood vessels (microaneurysms) and fatty deposits (exudates) in the eye is a warning sign that more severe retinopathy may develop.

Maculopathy
Maculopathy occurs when the central area of the retina, where most of the light sensitive cells which give us our central vision, is affected. Maculopathy can be exudative, with leakage of fluid, protein and fats into the retina, blurring, obscuring or distorting vision. Laser treatment and control of cholesterol and fats may be of some benefit. Maculopathy can also be ischaemic, again with visual blurring. This form of maculopathy is untreatable: prevention by good control of diabetes and hypertension is the best management.

Proliferative retinopathy
This occurs when capillaries become blocked. This starves the retina of nutrients, in response to which new vessels grow. These new vessels are fragile and can bleed into the vitreous. This gives rise to floaters, that if severe, cloud the vision or cause loss of vision. If vessels grow on the iris they cause an increase in the pressure in the eye and cause severe and painful glaucoma. The new vessels eventually produce scar tissue, which may result in a retinal detachment with severe loss of sight.

Further Information and Example Images
For more information regarding diabetic retinopathy and to view a larger selection of images please visit the University of Wisconsin website.