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• Blurred vision
• Sudden loss of vision in one eye
• Seeing rings around lights
• Dark spots or flashing lights

The symptoms described above may not necessarily mean that you have diabetic retinopathy. However, if you experience one or more of these symptoms, contact your ophthalmologist for a complete exam. It is also important to note that pregnancy and high blood pressure may aggravate diabetic retinopathy.

Macular edema and proliferative diabetic retinopathy can be assessed through a dilated eye exam. In addition, tests such as a fluorescein angiogram and ocular coherence tomography (OCT) can be conducted. The angiogram test involves the injection of a contrast agent or dye into your arm. The contrast agent can then be seen coursing through the blood vessels in your retina. Normal, healthy blood vessels do no leak. However, damaged blood vessels in patients with macular edema will leak. In addition, the new vessels that develop in proliferative diabetic retinopathy also will leak the contrast agent. In this way, the damaged vessels and abnormal new vessels are identified. 

Macular edema also can be assessed by using an OCT. This test uses light in a manner similar to ultrasound. The light is reflected back from the different layers of the retina and a cross sectional image of the retina is produced. Macula edema is noted when areas of your retina are shown to contain spaces filled with fluid.

In mild cases, treatment for diabetic retinopathy is not necessary. Regular eye exams are critical for monitoring progression of the disease. Strict control of blood sugar and blood pressure levels can greatly reduce or prevent diabetic retinopathy. In more advanced cases, treatment is recommended to stop the damage of diabetic retinopathy, prevent vision loss, and potentially restore vision.

Treatment options include:

• Anti-VEGF therapy (Avastin, Lucentis, Eylea): Anti-VEGF therapy involves the injection of the medication into the back of your eye. The medication is an antibody designed to bind to and remove the excess VEGF (vascular endothelial growth factor) present in the eye that is causing the disease state. The FDA has approved Lucentis for macular edema and additional treatment options include Avastin and Eylea.
• Intraocular steroid injection: Intraocular steroid injection is a treatment for diabetic macular edema. This therapy helps reduce the amount of fluid leaking into your retina, resulting in visual improvement. Due to the chronic nature of diabetic eye disease, this treatment may need to be repeated or combined with laser therapy to obtain maximum or lasting effect.
• Laser surgery: Laser surgery is often helpful in treating diabetic retinopathy. To reduce macular edema, a laser is focused on the damaged retina to seal leaking retinal vessels. For abnormal blood vessel growth (neovascularization), the laser treatments are delivered over the peripheral retina. The small laser scars that result will reduce abnormal blood vessel growth and help bond the retina to the back of your eye, thus preventing retinal detachment. Laser surgery may be performed in your ophthalmologist's office or in an outpatient clinic. Laser surgery can greatly reduce the chance of severe visual impairment.
• Vitrectomy: Vitrectomy may be recommended in advanced proliferative diabetic retinopathy. During this microsurgical procedure that is performed in the operating room, the blood-filled vitreous is removed and replaced with a clear solution. Your ophthalmologist may wait several months to a year to see if the blood will clear on its own before going ahead with surgery. In addition to a vitrectomy, retinal repair may be necessary if scar tissue has detached the retina from the back of your eye. Severe loss of vision or even blindness can result if surgery is not performed to reattach the retina. 

Watch these video animations to learn more about diabetic retinopathy, the affect that the diabetic retinopathy has on the eyes, and tests and treatments options for the condition.

Topics covered

• Vitreous Hemorrhage
• Macular Edema and Macular Ischemia
• Non-proliferative Diabetic Retinopathy (NPDR)
• Proliferative Retinopathy (PDR)
• Fluorescein Angiography Test
• Ocular Coherence Tomography (OCT) Test
• Ultrasound Test
• Anti-VEGF therapy (Avastin, Lucentis, Eylea) Treatment
• Laser Surgery Treatment
• Vitrectomy Treatment
• Panretinal Photocoagulation (PRP) Treatment
• Diabetic and Your Eyes