Retina · Diabetic ophthalmology

Diabetic retinopathy

Diabetic retinopathy is damage to the retinal blood vessels caused by diabetes. It often progresses without symptoms in the early stages, which is why regular screening and follow-up are so important.

Retinal examination during ophthalmic monitoring for diabetes

What is diabetic retinopathy?

Diabetic retinopathy is damage to the small blood vessels of the retina caused by diabetes. Over time, persistently high blood sugar weakens these vessels, which may leak fluid, become blocked, or proliferate abnormally. The retina, poorly supplied with blood, eventually suffers.

It is one of the leading causes of vision loss related to diabetes. It most often progresses without any symptoms in the early stages: this is precisely why regular screening matters, allowing action to be taken before vision is affected.

Diabetic retinopathy can be present without the patient being aware of it: the absence of visual disturbance does not mean the absence of damage. Only regular follow-up can detect it early.

Healthy retina Microaneurysms, haemorrhages
Schematic, non-anatomical illustration: diabetes causes microaneurysms and haemorrhages in the retinal blood vessels.

Stages of retinopathy

Diabetic retinopathy progresses through stages, from the mildest to the most severe. Distinguishing between them allows monitoring and treatment to be adapted accordingly.

Non-proliferative retinopathy

The earliest stage: the blood vessels become weakened (microaneurysms, small haemorrhages) without the formation of abnormal new vessels. It is often without symptoms and requires monitoring.

Proliferative retinopathy

A more advanced stage: the poorly perfused retina produces abnormal, fragile new vessels, which carry a risk of complications (haemorrhage, detachment). Treatment is required, often with laser.

Diabetic macular oedema

Fluid accumulates in the macula and blurs central vision. It can occur at various stages and is treated notably with injections. See the page on diabetic macular oedema.

Factors affecting progression

Several factors influence the risk and severity of retinal damage:

  • the duration of diabetes;
  • blood sugar control (glycaemic control);
  • blood pressure and other vascular risk factors;
  • certain periods (pregnancy, rapid change in glycaemic control).

Symptoms

Retinopathy is silent for a long time. When they do appear, signs may include:

  • a gradual or sudden deterioration in vision;
  • floaters or spots (in the event of haemorrhage);
  • distorted central vision (in the event of macular oedema).

The absence of symptoms does not mean the absence of damage: this is why regular follow-up is essential.

Diagnosis

Fundus examination and retinal imaging allow diabetic retinopathy to be detected and classified. This is where Dr Gattoussi's expertise in retinal imaging is particularly valuable.

  • Fundus examination and retinal photography: visualise the lesions;
  • OCT: detects and measures macular oedema;
  • Angiography: assesses retinal circulation depending on the situation.

Learn more about screening

Management

Management depends on the stage and always combines diabetes control with appropriate ophthalmic monitoring.

  1. 1

    Screening and classification

    Fundus examination and imaging to determine the stage.

  2. 2

    Diabetes control

    In conjunction with your GP and diabetologist: the cornerstone of management.

  3. 3

    Treatment if required

    Laser treatment and/or intravitreal injections depending on the stage and macular involvement.

  4. 4

    Regular follow-up

    Close monitoring to detect any deterioration.

Frequently asked questions

How often should eye checks be done when diabetic?

A monitoring frequency is defined according to your situation (type of diabetes, glycaemic control, existing damage). See the screening page.

Can diabetic retinopathy be prevented?

Diabetes control, blood pressure management, and regular follow-up play a major role in preventing its onset and progression.

Can diabetic retinopathy cause blindness?

At advanced and untreated stages, it can threaten vision. This is precisely what screening and early management aim to prevent.

See also

Book an appointment

Consult Dr Gattoussi

Ophthalmology practice in Paris 11th. Online appointments via Doctolib, at any time. Sector 2 fees.