Diabetic retinopathy

Diabetic retinopathy  is a diabetes-related complication that affects the eyes.

At first, the complication may not cause any clinical symptoms, or if it does, they may be so mild that no attention is paid to them.

Later, however, retinal damage may progress and become a cause of blindness.

Diabetic retinopathy is the leading cause of blindness among patients under 50 years of age. Patients often seek medical help when eye involvement is already at a very advanced stage. It should be known that with proper and timely treatment, the probability of vision loss due to diabetic retinopathy is greatly reduced. Thanks to modern advances in science and medicine, early diagnosis of retinopathy is possible, allowing treatment to begin earlier.


Diabetic retinopathy is caused by changes in the blood vessels of the retina. It is damage to the smallest retinal blood vessels. In the early stages, microscopic hemorrhages in the retina are observed due to red blood cells leaking through the damaged capillary walls.
Progression of the disease leads to two main complications, each of which can cause vision loss through a different mechanism and requires urgent treatment.
The first complication is macular edema (swelling of the macula/yellow spot), caused by excessive permeability of damaged capillary walls. This is the so-called  non-proliferative form—much more common and milder, but very often accompanied by the development of diabetic macular edema, meaning increased retinal thickness in the macular area and significantly reduced visual acuity.

Второто усложнение се състои в прорастването на нови, дефектни, лесно кървящи кръвоносни съдове (proliferative diabetic retinopathy), caused by blockage of larger vessels and severe impairment of retinal blood supply. This form is less common but much more severe in manifestation and prognosis.

Диабетната ретинопатия мoжe дa ce квaлифициpa дaли e в paнeн или нaпpeднaл cтaдий в зaвиcимocт oт пpoявeнитe пpизнaци и cимптoми:

1. Early form (non-proliferative) – growth of new blood vessels has not yet begun. Non-proliferative diabetic retinopathy may be described as mild, moderate, or severe.

In this form, the walls of retinal blood vessels weaken. Small bulges called microaneurysms appear, from which fluid or blood may leak.

As the complication progresses, smaller vessels close off, while larger ones begin to dilate and their outer surface becomes irregular.

The nerve fibers in the retina often begin to swell. Sometimes the center of the retina (macula) also starts to swell. This condition is better known as macular edema

2. Advanced form (proliferative) – new blood vessels begin to grow in the retina, but their shape is abnormal.

They usually appear in the jelly-like substance filling the center of the eye.

Later, connective tissue stimulated by the growth of new blood vessels may lead to retinal detachment from the back of the eye.

If the new blood vessels obstruct the normal drainage of fluid from the eye, intraocular pressure rises, causing glaucoma.

This may damage the nerve that carries visual images from the eye to the brain (optic nerve).