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Are There Different Types of Diabetic Retinopathy?

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Are There Different Types of Diabetic Retinopathy?

Yes, there are different types of diabetic retinopathy, if you’re too impatient to know the answer right away, but ‘what’ and ‘how’ remain more significant areas to cover if you really want to learn more about it. So, let’s recap major aspects of DR before actually exploring through its major types.

One of the most common eye conditions, diabetic retinopathy, also known as ‘DR’ is considered as one of the leading causes of blindness not only in the U.S, but also across the globe.

According to some figures shared by ‘Prevent Blindness America’:

Diabetic retinopathy’s national prevalence rate for U.S. population above 40 is 5.4%, which means about 7.7 million American adults are suffering from DR.

Diabetic retinopathy is a complication of diabetes, which damages the blood vessels within the retina of the eye – a thin membrane comprising of light sensitive tissues, lining the back of the eye. Damage caused by DR leads to blood and fluid leakage into the retina, distorting the vision ultimately.

  • Diabetes leads to the blood vessel damage in the retina, distorting the vision eventually.

  • Blurriness in the vision, floaters, difficulty seeing colors and even total vision loss are some of the symptoms of diabetic retinopathy.

  • People suffering from diabetes should get an eye exam at least once a year to rule out DR.

  • Symptoms can be relieved by various retinal surgeries, but managing diabetes remains the most effective way of diabetic retinopathy prevention.

Types of Diabetic Retinopathy

Now, getting to the types of diabetic retinopathy; it is classified into two major types, i.e. ‘Non Proliferative Diabetic Retinopathy (NPDR)’ or ‘Early Diabetic Retinopathy’ and ‘Proliferative Diabetic Retinopathy (PDR)’ or ‘Advanced Diabetic Retinopathy’.

1:          Non Proliferative Diabetic Retinopathy (NPDR)

Referred as the ‘Nonproliferative Diabetic Retinopathy’, the most commonly existing of the two forms of the disease, it is considered as the early stage of DR where there is no abnormal growth of blood vessels (proliferation).

NPDR weakens the walls of your retinal blood vessels. This leads to protrusion of ‘microaneurysms’ from the walls of the smaller blood vessels, sometimes causing fluid and blood leakage into the retina.

It also causes dilation of larger retinal vessels, disturbing their natural diameter. As more and more blood vessels get blocked, NPDR progresses from mild to severe. This can also cause swelling in the micro nerve fibers of the retina, as a result of which the macula (the central most region of the retina) also begins to swell.

2:          Proliferative Diabetic Retinopathy (PDR)

As diabetic retinopathy increases in severity, it can progress to this advanced stage commonly known as proliferative diabetic retinopathy. By this stage, the earlier damaged blood vessels are closed off, stimulating the growth of new, abnormal blood vessels within the retina, which are most likely to leak blood and fluid into the clear, jelly-like substance filling the central area of your eye (vitreous).

This abnormal growth of blood vessels inside the retina also stimulates the growth of scar tissue, which may eventually lead to the detachment of retina from the back of the eye. There is also a probability of the new blood vessels interfering with the normal flow of eye-fluid, resulting in increased pressure-buildup in the eyeball. This can also inflict damage to the optic nerve, the central nerve connecting your eye with the brain, resulting in glaucoma.

Stages of Diabetic Retinopathy

Some experts also like to consider the different stages of the disease to classify diabetic retinopathy. So, let’s see what the different stages of diabetic retinopathy are:

  • Mild Nonproliferative Retinopathy: This is the initial stage of the disease, represented by microaneurysms, formation of small balloon-like swellings inside the retina’s tiny blood vessels.

  • Moderate Nonproliferative Retinopathy: By this stage, the blood vessels nourishing the retina are blocked due to a significant increase in number and size of those balloon-like swellings or microaneurysms.

  • Severe Nonproliferative Retinopathy: At this stage, a considerable number of blood vessels are blocked, which leads to deprivation of blood supply to several areas of the retina. This triggers the growth of new blood vessels as a result of the signals sent by the retina to the brain, to compensate for lost blood supply and nourishment.

  • Proliferative Retinopathy: This is the most advanced stage of DR progress, whereby a sizeable growth of new blood vessels occurs due to the retina’s signal to the brain for compensation of lost nourishment. These new abnormal blood vessels are quite fragile and prone to damage and leakage of blood and fluid inside the retina, also trespassing into the clear, vitreous gel constituting the white region of the eye. Prolonged blood and fluid leakage can cause severe vision loss or even blindness.

Diabetic Retinopathy Treatment

Various approaches can be used for treatment of diabetic retinopathy, such as:

  • Managing Your Lifestyle: Improving your overall lifestyle remains one of the best ways to fight against any health problem including DR. This will help you control your blood pressure and blood sugar levels to prevent vision loss, as it will keep your eye’s blood vessels healthy and efficient. Improving your diet intake is also a major part of lifestyle management aimed at countering DR.

  • Medication: To treat diabetic retinopathy, many ophthalmologists readily recommend Anti-VEGF (anti vascular endothelial growth factor) therapy based on drugs like Eylea, Avastin and Lucentis. This treatment needs to be administered as shots (injections) within the eye.

  • Laser Surgery: Laser surgery helps greatly when eye doctors want to seal off the leaking retinal blood vessels and reduce retinal swelling. When blood vessels are shrunk using laser surgery, further growth stops in them. Sometimes, multiple surgeries are required to serve the purpose.

  • Vitrectomy: Vitrectomy serves best in dealing with advanced stage retinopathy (PDR) by removing blood from the leaking vessels in the back of the eye. It is also helpful in removing scar tissues from the retina.

  • Alternate Solutions: These involve innovative low vision aids like IrisVision, designed to enhance vision for people affected by diabetic retinopathy and other degenerative eye diseases like macular degeneration.

One of the best ways to make sure you carry a healthy pair of eyes for a long time is to never skip your eye exam. It helps ophthalmologists pick up any signs and symptoms of irregularities developing in your eye well in time, offering them ample time and resources to devise the best course of action to deal with your eye issues.