Non-Proliferative Diabetic Retinopathy
Non-Proliferative diabetic retinopathy (NPDR) is a complication of diabetes caused by changes in the blood vessels of the back of the eye. If you have diabetes, your body does not use and store sugar properly. High blood sugar levels cause damage to the veins, arteries, and capillaries that carry blood throughout the body. This damage also occurs in the tiny blood vessels in the retina. The retina is the light-sensitive nerve layer that lines the back of the eye.
Mild forms of NPDR are sometimes called background retinopathy. Many people with diabetes have mild NPDR, which usually does not affect their vision.
When vision is affected, it is the often result of the tiny blood vessels within the retina leaking fluid. This leaking fluid can cause swelling or thickening in the retina. When it occurs in the macula, a small area in the center of the retina that allows us to see fine details clearly, it is called macular edema. The swelling is caused by fluid leaking from retinal blood vessels. It is the most common cause of visual loss in diabetes. Vision loss may be mild to severe. Laser treatment or injections of medicines may be used to help control vision loss from macular edema.
In other cases when vision is affected, it may be the result of the tiny blood vessels within the retina closing off. Macular ischemia occurs when small blood vessels (capillaries) within the macula close. Vision blurs because the macula no longer receives sufficient blood supply to work properly. Unfortunately, there are no effective treatments for macular ischemia.
An eye examination is the only way to discover any changes inside your eye. If your eye doctor finds diabetic retinopathy, he or she may order color photographs of the retina, a special test called fluorescein angiography (see section on fluorescein angiography), or optical coherence tomography (OCT) for further evaluation.
If you have diabetes, early detection of diabetic retinopathy is the best protection against loss of vision. You can significantly lower your risk of vision loss by maintaining strict control of your blood glucose and visiting your eye doctor regularly. People with diabetes should schedule an eye examination at least once a year. Pregnant women with diabetes should schedule an appointment in their first trimester, because retinopathy can progress quickly during pregnancy. More frequent medical eye examinations may be necessary after a diagnosis of diabetic retinopathy.
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