What Are the Four Stages of Diabetic Retinopathy?

Medically Reviewed on 10/12/2020

Diabetic retinopathy is a condition that affects a person with diabetes.
Diabetic retinopathy is a condition that affects a person with diabetes.

The four stages of diabetic retinopathy include:

  • Mild nonproliferative retinopathy (background retinopathy): In this stage, there are small areas of balloon-like swelling in the tiny blood vessels of the retina. These swellings, also known as microaneurysms, may cause the vessels to leak small amounts of blood in the retinas. At this stage, the person may not exhibit vision problems; however, one should monitor their blood sugar, blood cholesterol levels, and blood pressure to prevent progression to the third stage.
  • Moderate nonproliferative retinopathy (pre-proliferative retinopathy): In this stage, the tiny vessels of the retina swells, obstructing the blood flow. This can cause physical damage to the retina. Blood and other fluids build up in the small central part of the retina (macula), causing a problem with the important part of the vision. This condition is known as diabetic macular edema. Most of the people with diabetic retinopathy will get diabetic macular edema. Advancement to this stage indicates that the vision has been affected significantly.
  • Severe nonproliferative retinopathy (proliferative retinopathy): In this stage, the blood vessels become even more congested, thus limiting the blood flow to the retina. The lack of blood triggers a signal to the retinas to create a new blood vessel. Macular ischemia is a condition in which the blood vessels are obstructed completely, leading to blurry vision with dark spots in the field of vision known as floaters. This stage can increase the risk of vision loss.
  • Proliferative diabetic retinopathy: At this advanced stage, the signals sent by the retina triggers the growth of abnormal and fragile new blood vessels. They grow along the retina and the surface of clear, vitreous gel present inside the eyes. As these blood vessels have fragile walls, they may leak a considerable amount of blood, causing severe vision loss and blindness.

What is diabetic retinopathy?

Diabetic retinopathy is a condition that affects a person with diabetes. This happens when high blood sugar levels cause damage to blood vessels in the retina. In some, the blood vessels swell and leak or can obstruct the blood flow whereas, in some, there may be a growth of abnormal new vessels on the surface of the retina. All these changes can lead to vision loss or permanent blindness. Diabetic retinopathy usually affects both eyes.

What are the symptoms of diabetic retinopathy?

Diabetic retinopathy hardly manifests any symptoms during the early stages. As the diabetic retinopathy progresses, the following symptoms may be observed:

  • Blurry vision
  • Losing vision
  • Poor night vision
  • Noticing colors appear faded or washed out
  • Increased number of floaters
  • Seeing blank or dark areas the field of vision
  • A vision that sometimes changes from blurry to clear

How is diabetic retinopathy treated?

Treatment of diabetic retinopathy mainly involves controlling blood sugar levels. When diabetic retinopathy progresses to diabetic macular edema, the eye specialist may prescribe various treatment options, which include:

  • Injecting the anti-VEGF medications that include Avastin, Eylea, and Lucentis into the eye to reduce swelling and improve vision
  • Steroid injections may also help to reduce macular swelling
  • Laser surgery might help seal the leaking blood vessels
  • Vitrectomy may be recommended in advanced proliferative diabetic retinopathy

Regular eye check-ups are necessary to prevent vision loss and further eye complications.


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Medically Reviewed on 10/12/2020