Diabetic retinopathy

Sight-threatening signs include macular oedema, retinal or optic disc new vessels, and vitreous haemorrhage.

Main measures to prevent visual loss include improvement in glycaemic, lipid, and hypertensive control, and the identification of sight-threatening disease before visual loss occurs.

Main therapies are intravitreal injection of anti-vascular endothelial growth factor (VEGF) agents, macular and pan-retinal laser photocoagulation, and vitrectomy surgery. Intravitreal corticosteroid therapy may be considered for patients refractory to anti-VEGF.

Diabetic retinopathy is the retinal consequence of chronic progressive diabetic microvascular leakage and occlusion. It eventually occurs to some degree in all patients with diabetes mellitus. There are two types: non-proliferative and proliferative. Non-proliferative diabetic retinopathy (NPDR) is the early stage of the disease and is less severe. Blood vessels in the eye may leak fluid into the retina, which leads to blurred vision. Proliferative diabetic retinopathy (PDR) is the more advanced form of the disease. New blood vessels start to grow in the eye (neovascularisation), which are fragile and can haemorrhage. This may cause vision loss and scarring of the retina.