Diatebic rethinopathy
What is diabetic retinopathy?
Diabetic retinopathy is a disease of the retina caused by prolonged elevated blood sugar levels.
High blood sugar damages the small blood vessels in the eye - leading to leakage, blockage, or the growth of new, abnormal blood vessels.
If left untreated, it can lead to vision impairment or even blindness.
How does it develop?
In people with diabetes - regardless of type - changes in the retinal blood vessels develop over time:
blood vessel walls become weaker
leakage of fluid and blood occurs
oxygen supply decreases
new but abnormal blood vessels form
Risk increases with the duration of uncontrolled diabetes.
Who is at risk?
People with a higher risk include those who:
have had diabetes for a long time
have poorly controlled blood sugar
have high blood pressure
have elevated blood fats
Diabetic retinopathy can be present without symptoms in the early stages - which is why regular ophthalmological check-ups every 6 months are mandatory for people with diabetes.
Types of diabetic retinopathy
Non-proliferative diabetic retinopathy (NPDR)
An early stage of the disease - blood vessel damage and leakage occur, but without the formation of new vessels.
There are often no symptoms, or symptoms are mild.
Proliferative diabetic retinopathy (PDR)
An advanced stage - new, abnormal blood vessels form and may bleed.
This condition can lead to sudden deterioration of vision and serious complications - including retinal detachment and glaucoma.
Diabetic maculopathy
A condition in which swelling or damage to the macula (the central part of the retina) occurs. It encompasses macular oedema and macular ischaemia.
The most common cause of vision loss in patients with type 2 diabetes.
What are the symptoms?
In the early stages there are often no visible symptoms. Later, patients may notice:
blurry vision
dark spots or "floaters" in vision
difficulty reading
sudden deterioration of vision
Symptoms often appear only once the disease has already progressed significantly.
How is it diagnosed?
Diabetic retinopathy is detected with a detailed ophthalmological examination:
retinal photography
Regular check-ups are key - to monitor the condition of the fundus even when there are no symptoms.
How is it treated?
Managing the underlying condition
The most important measure is good metabolic control of diabetes - satisfactory glycaemic regulation (HbA1c < 7%) - together with good cholesterol and triglyceride levels, treatment of arterial hypertension, and smoking cessation.
Laser treatment
Laser photocoagulation (LFC) is performed to stop leakage and the growth of new blood vessels - which can slow or halt disease progression, though lost visual acuity cannot be restored.
Anti-VEGF therapy
Anti-VEGF injections reduce swelling and prevent further disease progression by blocking the growth of new blood vessels - reducing the risk of bleeding, leakage, scarring, and further vision loss.
Surgical treatment (vitrectomy)
If these rules of regulation and treatment are not followed, diabetic retinopathy leads to irreversible vision loss due to the most severe complications: tractional retinal detachment and neovascular glaucoma. If the disease progresses to its proliferative form, surgical intervention vitrectomy becomes necessary.
Why are regular check-ups essential?
Diabetic retinopathy can progress for a long time without symptoms - while timely detection enables treatment and vision preservation.
People with well-controlled diabetes are recommended to have an ophthalmological examination once a year. Those with poorly controlled diabetes should have a check-up every 6 months or more often - in agreement with their doctor.
Frequently asked questions
When should a person with diabetes have their first fundus examination?
At the time of diagnosis. With type 2 diabetes in particular, it is important not to delay - because the disease often exists for some time before it is discovered, meaning retinal changes may already be present. With type 1 diabetes, an examination is recommended within the first 5 years of diagnosis.
Can pregnancy affect diabetic retinopathy?
Yes. Pregnancy can accelerate the progression of retinopathy in women with diabetes - especially if blood sugar is poorly controlled. Women with diabetes are therefore advised to have an ophthalmological examination before planning a pregnancy, at the start of pregnancy, and during it.
Diabetes affects vision - often without warning.
Regular check-ups are the only way to detect retinopathy in time - schedule a check-up and do not wait for symptoms.