diabetic retinopathy stages

Stages of Diabetic Retinopathy


Stages of Diabetic Retinopathy at Center for Sight serving Fall River, Massachusetts and greater Providence, Rhode Island

By Robert Kelly, M.D.

background diabetic retinopathy

Mild Nonproliferative Retinopathy
Mild Nonproliferative Retinopathy is the earliest stage of Diabetic Retinopathy. It is characterized by the presence of “dot” and “blotch” hemorrhages and “microanuerysms” in the Retina during your eye examination.  Microanuerysms are areas of balloon like swelling of the tiny blood vessels in the Retina caused by the weakening of their structure.  Mild Nonproliferative Retinopathy can be present without any change in your vision.  Mild Nonproliferative Retinopathy usually does not require treatment unless it progresses or if it is accompanied by Diabetic Macular Edema.  If you have Mild Nonproliferative Retinopathy, your doctor will make specific recommendations about how often you will need to be reexamined.

 

Moderate Nonproliferative Retinopathy 
nonproliferative retinopathyModerate Nonproliferative Retinopathy is the second and slightly more severe stage of Diabetic Retinopathy. During this stage, some of the small blood vessels in the Retina may actually become blocked.  The blockage of these tiny blood vessels causes a decrease in the supply of nutrients and oxygen to certain areas of the Retina.

The best way to diagnose blockage of the small blood vessels in the Retina is by having a diagnostic test called an Intravenous Fluorescein Angiogram (IVF).  The Intravenous Fluorescein Angiogram is performed right in our office by Center for Sight Retinal Specialist Robert Kelly, M.D.  Dr. Kelly begins the IVF by injecting a fluorescent dye into a vein in your arm and then, using a specialized camera, takes a series of photographs of the Retina as the dye circulates throughout the retinal blood vessels. Using the IVF, it is possible for Dr. Kelly to precisely and directly observe the circulation and the integrity of the blood vessels in the Retina so that he can identify any blood vessels that may be blocked.

Severe Nonproliferative Retinopathy 
Severe Nonproliferative Retinopathy is the next progression of Diabetic Retinopathy.  Severe Nonproliferative Retinopathy is characterized by a significant number of small blood vessels in the Retina becoming blocked.  As a greater number of blood vessels become blocked, it results in more areas of the Retina being deprived of nourishment and oxygen.  A lack of sufficient oxygen supply to the Retina results in a condition called “Retinal Ischemia”.  To attempt to compensate for “Retinal Ischemia”, these areas of the Retina then send signals to the body to stimulate the growth of new blood vessels in order to try and reestablish the supply of oxygen.

Proliferative RetinopathyProliferative Retinopathy
Proliferative Retinopathy is a stage of Diabetic Retinopathy that carries a significant risk of vision loss.  The Retina responds to a lack of oxygen, or ischemia, by attempting to compensate for the reduced circulation by growing new, but abnormal blood vessels-a process called neovascularization.  When Retinal Neovascularization is present, you have progressed into the Stage of Diabetic Retinopathy called Proliferative Retinopathy.  At first, it might seem that new blood vessel growth or neovascularization is a desirable event enabling greater blood flow and thus providing more oxygen and nutrients.  However this is not the case at all.  Retinal Neovascularization is formed from abnormal blood vessels that are extremely fragile and tend to break easily and hemorrhage into the Vitreous.  If left untreated, Proliferative Retinopathy will result in hemorrhaging into the Vitreous that leads to scarring and ultimately to retinal detachment with profound vision loss, even blindness.

 

Proliferative Retinopathy is treated with either Panretinal Laser Photocoagulation Treatment alone or Panretinal Laser Photocoagulation Treatment in conjunction with a surgical procedure called a Vitrectomy. During a Vitrectomy, the surgeon will remove the Vitreous that has been filled with blood or scar tissue.

click to view vitrectomy procedure

It may be possible for patients to have Proliferative Retinopathy and Retinal Neovascularization and yet still have good vision.  Even if Proliferative Retinopathy and Retinal Neovascularization do not appear to be causing any vision loss, it is critical that you be treated as quickly as possible in order to stop the progression and preserve the good vision.

If you have been diagnosed with diabetes or even if you are just glucose intolerant, you may be at risk for Diabetic Retinopathy and you should have a thorough diabetic eye examination at Center for Sight. Please call us in Fall River, Massachusetts at 508-730-2020.

Center for Sight is conveniently located for diabetic patients in need of evaluation, diagnosis and treatment of diabetic retinopathy in Massachusetts or Rhode Island from Attleboro, Fairhaven, Fall River, Franklin, Mansfield, Marion, Mattapoisett, Medfield, Milford, New Bedford, North Attleboro, North Dartmouth, Norton, Oxford, Rehoboth, Somerset, Swansea, Taunton, Walpole, Whitinsville, Woonsocket, Providence, Smithfield, Westport, Lakeville, Dighton, Little Compton and Tiverton.