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SERVICES / MACULAR DEGENERATION

Diabetic Retinopathy

Diabetic retinopathy is one of the most common complications of diabetes mellitus and one of the leading causes of vision loss among adults worldwide.

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Retinal Diseases
Retinal Detachment
Age-Related Macular Degeneration
Macular Hole
Retinal Membrane
Retinopathy of Prematurity
Cystic Edema of the Yellow
Diabetic Retinopathy
Retinal Vein Occlusion
Eye Inflammation – Uveitis
Treatments for Retinal Diseases

What is diabetic retinopathy?

Diabetic retinopathy is one of the most common complications of diabetes mellitus and one of the leading causes of vision loss among adults worldwide.

It occurs when long-term changes in blood glucose levels damage the small blood vessels of the retina—the light-sensitive layer at the back of the eye that functions like the sensor of a camera.
This damage may lead to:
  • leakage of fluid or blood from retinal vessels
  • swelling of the macula (diabetic macular edema)
  • reduced blood supply to parts of the retina (ischemia)
  • formation of abnormal new blood vessels
  • retinal detachment
  • increased eye pressure due to abnormal vessel growth
Without early diagnosis and appropriate treatment, diabetic retinopathy can result in severe and sometimes permanent vision loss.

Types of Diabetic Retinopathy

1. Non-Proliferative Diabetic Retinopathy (NPDR)

This is the earlier stage of the disease.
At this stage:
  • small retinal blood vessels become damaged and may leak fluid or blood
  • deposits called exudates may develop
  • swelling of the retina can occur
  • some retinal capillaries may become blocked, reducing blood supply
Many patients have no symptoms and maintain good vision despite significant retinal changes. This is why regular screening examinations are essential.

Diabetic Macular Edema

Diabetic macular edema is one of the most common causes of vision loss in patients with diabetes.

It occurs when damaged blood vessels leak fluid into the macula—the central area of the retina responsible for sharp vision, reading, and recognizing faces.

Macular Ischemia

Macular ischemia occurs when the small blood vessels supplying the macula become blocked.

2. Proliferative Diabetic Retinopathy (PDR)

This is the advanced stage of diabetic retinopathy and can lead to serious vision-threatening complications.
When the retina does not receive enough oxygen, it stimulates the growth of abnormal new blood vessels (neovascularization).
These vessels:

  • are fragile
  • bleed easily
  • are associated with scar tissue formation
  • may create traction on the retina
Possible complications include:
  • Vitreous hemorrhage
    Bleeding inside the eye, causing floaters, blurred vision, or sudden severe vision loss.
  • Tractional retinal detachment
    Scar tissue pulls the retina away from its normal position, potentially causing permanent visual damage.
  • Neovascular glaucoma
    Abnormal blood vessel growth can block normal fluid drainage from the eye, leading to dangerously increased eye pressure and damage to the optic nerve.

Symptoms

In the early stages, diabetic retinopathy often causes no symptoms.

As the disease progresses, patients may experience:
  • blurred vision
  • difficulty reading
  • distortion of straight lines
  • dark spots in the center of vision
  • floaters
  • sudden loss of vision due to bleeding inside the eye
  • pain or redness in cases of neovascular glaucoma
Importantly, the absence of symptoms does not exclude the presence of advanced diabetic eye disease.

Diagnosis

Diagnosis is based on a comprehensive ophthalmic examination, which may include:

Dilated retinal examination

Allows evaluation of retinal blood vessels, hemorrhages, exudates, swelling, and abnormal new vessels.

Fluorescein angiography

Evaluates retinal circulation and identifies areas of leakage, poor blood supply, or abnormal blood vessel growth.

OCT (Optical Coherence Tomography), including OCT angiography

Provides high-resolution cross-sectional images of the retina and is essential for detecting and monitoring diabetic macular edema.
At Athens Vision, advanced wide-field fluorescein angiography and OCT imaging systems allow detailed assessment and accurate monitoring of diabetic retinal disease.

Treatment

1. Prevention – the most important treatment

The foundation of diabetic eye care is prevention.
Large international studies have shown that:
  • good blood glucose control
  • control of blood pressure
  • management of cholesterol and other cardiovascular risk factors
significantly reduce the risk of developing diabetic retinopathy and vision loss.

3. Laser Treatments

It is used to treat many forms of the disease:
Yellow laser (for edema)
  • Targets leaky blood vessels
  • Improves vision
  • In some cases, it also offers improvements
Peripheral laser (PRP) for the production stage
  • Used mainly for proliferative diabetic retinopathy.
  • It reduces the stimulus for abnormal blood vessel growth and lowers the risk of severe bleeding and retinal detachment.
  • Prevents bleeding and future detachments
Laser treatment does not cure the disease, but it prevents its dangerous complications.

3. Intraocular injections

They are used primarily in cases of macular edema and proliferative retinopathy.
Anti-VEGF therapy
Anti-VEGF medications reduce abnormal blood vessel growth and decrease fluid leakage, often leading to stabilization or improvement of vision.
Corticosteroid injections or implant
Used in selected patients to reduce inflammation and macular swelling

4. Vitrectomy Surgery

Vitrectomy may be necessary in advanced cases, such as:
  • persistent vitreous hemorrhage
  • tractional retinal detachment or macular edema
  • advanced proliferative diabetic retinopathy
During surgery, blood, scar tissue, and the vitreous gel are removed, allowing restoration of the normal anatomy of the retina.

At Athens Vision, minimally invasive sutureless vitrectomy techniques are applied whenever indicated.

When should a patient with diabetes have an eye examination?

All patients with diabetes should undergo a complete eye examination at least once a year.
More frequent monitoring is required when:
  • diabetic retinopathy is present
  • macular edema has developed
  • the disease is advanced
  • pregnancy is planned or occurs in women with diabetes
Η έγκαιρη διάγνωση
Early diagnosis and timely treatment can prevent vision loss in the vast majority of patients.

την απώλεια όρασης σε συντριπτικό ποσοστό περιπτώσεων.

Conclusion

Diabetic retinopathy is a serious but highly manageable complication of diabetes.

With appropriate diabetes control, regular specialized eye examinations, modern imaging, and timely treatment, most patients can preserve useful vision throughout their lives.

Frequently Asked Questions

If you have diabetes or diabetic retinopathy, it is vital that you see an ophthalmologist regularly. They will recommend a schedule of regular follow-up visits, which can play a crucial role in the early detection of more serious changes before they become severe or permanent.

You should also call or visit your doctor if you notice any gradual changes in your vision, such as:

  • Loss of vision or difficulty seeing as well as you used to
  • Blurred or distorted vision
  • Areas in your field of vision that appear blurry, faded, or different from what you used to see

You should go to the emergency room if you experience SUDDEN changes in your vision, such as:

  • Severe eye pain
  • Complete loss of vision or severe loss of vision

A doctor who specializes in this condition

ALEXANDER CHARONIS

Ophthalmic Surgeon
Director of the Retina Department at AthensVision, Board Certified by the American and European Boards of Ophthalmology
Specialties: Vitreoretinal Surgery, Ocular Infections
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