UPMC Eye Center

Diabetic Retinopathy

Diabetic retinopathy is an eye condition that results from a loss of blood flow and oxygen to the eye, in particular, the retina.

The retina is located in the back of the eye. It collects light and turns it into a signal that is interpreted by the brain as vision. Diabetic retinopathy occurs when the retina does not receive enough blood because the vessels in the retina are damaged by high blood sugar.

This condition can lead to a range of problems ranging from a minor leakage of blood and plasma in the retina, to total blindness. Diabetic retinopathy is a leading cause of blindness in American adults, and usually affects both eyes.  

There are two kinds of diabetic retinopathy:

• non-proliferative diabetic retinopathy
  This condition can cause some mild bleeding,  swelling, and the formation of fatty deposits in the retina.

• proliferative diabetic retinopathy
  This condition occurs when diabetes is not well controlled and extensive blood vessel damage occurs. In this phase of the disease, in an attempt to gain nourishment, the retina grows new vessels. These vessels are abnormal and can lead to more leakage, retinal detachment, glaucoma, and in some cases, blindness. 

Risk Factors
Diabetic retinopathy occurs in about 40 percent of all Type 1 diabetics and 20 percent of all Type 2 diabetics. The longer one has been a diabetic, and the longer the condition has gone untreated, the higher the risk of diabetic retinopathy. Other risk factors include:

• pregnancy, especially when the mother is diabetic
• high blood pressure in diabetics
• high cholesterol in diabetics
• diabetic kidney disease

Keeping blood sugar at the right level can greatly reduce the chance of developing the condition, as well as control the effects if it does occur.    

Diagnosis
Diabetic retinopathy needs to be detected as early as possible. People with this condition may experience very few symptoms, or may have no symptoms at all. The retina is delicate, and, once injured, cannot always heal completely.

Anyone with diabetes should have an eye exam at least once a year. In order to diagnose diabetic retinopathy, your eye doctor will give you a complete eye exam. Your doctor will also discuss your medical history, including the medicines you are taking. Bring to your appointment a list of your medicines as well as any test results you have about your blood sugar levels.

Treatment
Once a diagnosis has been made and the degree of the retinopathy has been determined, an eye doctor will create a personalized treatment plan.  This plan can range from careful observation, to laser treatments which destroy part of the retina.

There are newer treatments in which steroids are injected directly into the eye, but the relief they offer is usually temporary. Steroids are also known to cause glaucoma and cataracts in some patients.

Other treatments for diabetic retinopathy include:

• Avastin® (bevacizumab) and other anti-angiogenic drugs to prevent the growth of new blood vessels in the eye
• laser treatments
• vitrectomy – removal of the vitreous, the part of the eye which gives it its round shape

For more information, or to make an appointment with an eye doctor, please contact the UPMC Eye Center at 412-647-2200.

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