Proliferative Diabetic Retinopathy

People who cannot control their blood sugar levels and people who do not manage their diabetes are prone to diabetes complications. Proliferative diabetic retinopathy is a serious diabetes complication of the eye that can lead to permanent vision loss. Affecting both type 1 and type 2 diabetes patients, it needs aggressive management to avoid blindness.

What is proliferative diabetic retinopathy?

Proliferative diabetic retinopathy is an advanced stage of diabetic retinopathy. People with diabetes have chronic high blood sugar levels. When this is not managed properly, it damages blood vessels in the retina. As blood vessels are damaged, they can no longer supply nutrients and oxygen to retinal cells. Over a period of time, cells of retina stop functioning normally.

In initial diabetic retinopathy stages, there are no changes in vision. In non-proliferative diabetic retinopathy, vision remains more or less normal, but there are changes in the retina with microaneurysms, cotton wool spots, and retinal hemorrhages. When this condition is not managed properly with medications and aggressive diabetes control, it leads to proliferative diabetic retinopathy.

In proliferative diabetic retinopathy, damage to small blood vessels reaches its peak. As a compensatory mechanism, new blood vessels start growing. This process is called neovascularization.

New blood vessels that start growing are fragile. They leak blood, and other material into the eye. When leakage is mild, it appears in the form of dark floaters in the eye. When leakage is heavy, it blocks vision.

New and fragile blood vessels also form scar tissue which leads to retinal detachment. Retinal detachment is a major cause for sudden vision loss. People with retinal detachment need medical procedures in order to reattach the retina. If this is not done, it leads to blindness.

Neovascularization is responsible for diabetic macular edema, glaucoma, retinal detachment and permanent vision loss.

Symptoms of Proliferative Diabetic Retinopathy

  • Changes in vision
  • Eye pain
  • Floaters(dark spots) in vision
  • Dark patches in field of vision
  • Blurred vision
  • Difficulty seeing colors
  • Double vision
  • Fluctuating vision

Proliferative Diabetic Retinopathy Risk Factors

  • High blood sugar levels
  • Poor diabetes control
  • Age of diabetes
  • High blood pressure
  • High cholesterol levels
  • Having other diabetes complications like diabetic kidney disease

Proliferative diabetic retinopathy symptoms are actually symptoms of a specific part that is damaged. When blood enters the vitreous, there is a sudden vision loss. Macular edema causes decreased vision.

Diagnosis of Proliferative Diabetic Retinopathy

Periodical dilated eye examinations are a must for people with diabetic retinopathy in order to assess damage and provide treatment. Other tests include:

  • Fundus Photography
  • Slit Lamp Examination
  • Fluorescein Angiography
  • Optical Coherence Tomography
  • B-scan Ultrasonography

Diabetic retinopathy is treated with medications (anti-VEGF medications), steroidal medication and surgical procedures like laser surgery and vitrectomy. Diabetic retinopathy needs long term management, but it can be prevented in early stages.

How to Prevent Proliferative Diabetic Retinopathy

  • Keep blood sugar levels in target range as suggested by doctor
  • Reach target HbA1c levels
  • Follow a diabetes diet plan as suggested by a nutritionist
  • Reduce high blood pressure
  • Reach target cholesterol levels
  • Get regular eye examinations
  • Quit smoking

Next: Proven methods to avoid diabetic retinopathy in people with diabetes – Apollo Sugar Clinics