Diabetic retinopathy is an eye disease that occurs as a consequence of diabetes mellitus. Persistently elevated blood sugar levels damage the fine blood vessels of the retina and, if untreated, can lead to significant vision loss up to and including blindness. It is one of the most common causes of visual impairment in working-age adults worldwide.
Diabetes mellitus is a metabolic disease in which the body cannot properly regulate blood sugar. The main types are:
High blood sugar levels damage blood vessels throughout the body — including the particularly sensitive vessels of the retina.
The small blood vessels of the retina are especially sensitive to fluctuations and elevated blood sugar levels. Initially, the vessel walls become permeable, leading to small bleedings and fluid accumulation in the retina. As the disease progresses, vessels can close, depriving parts of the retina of adequate oxygen supply. In response, the body forms new but inferior-quality blood vessels that can easily burst and cause larger bleedings.
In the early stage, small vessel outpouchings (microaneurysms), dot-shaped bleedings, and protein deposits (hard exudates) are found in the retina. Many patients notice no vision changes at this stage.
Fluid accumulates in the area of the macula (the site of sharpest vision). This leads to blurred or distorted vision and is the most common cause of vision deterioration in diabetes.
New, unstable blood vessels grow into the retina or vitreous body. These can bleed and form scars that, in the worst case, cause retinal detachment.
In addition to retinopathy, diabetes increases the risk of:
Diabetic retinopathy is detected through examination of the fundus with dilated pupils. Imaging procedures complement this:
The most important measure is consistent control of blood sugar, blood pressure, and blood lipids. Studies show that good metabolic control can significantly slow the progression of retinopathy.
For macular edema, medications (anti-VEGF preparations or steroids) are injected directly into the vitreous body of the eye. They inhibit the growth of pathological vessels and reduce swelling.
Targeted laser coagulation can seal leaking vessels and slow the growth of new, unstable vessels.
In advanced cases with vitreous hemorrhage or retinal detachment, vitrectomy (surgical removal of the vitreous body) may be necessary.
Because diabetic retinopathy progresses without symptoms for a long time, regular ophthalmological examinations are essential:
If you or your child has diabetes, attend the recommended eye examinations, even if vision seems good. The earlier changes to the retina are detected, the better the treatment options. Close cooperation between the primary care physician or diabetologist and the ophthalmologist is crucial.