Causes and Risk Factors

Diabetes causes high blood sugar, or glucose, levels. Over many years, this elevated glucose can damage tiny blood vessels and nerves in the retina. The main causes of high blood sugar are type 1 and type 2 diabetes.

Several risk factors can increase the chances of developing diabetic retinopathy, including:

- Duration of diabetes. The longer a person has diabetes, the greater the risk of developing retinopathy.

- Poor blood sugar control. Higher average blood sugar levels over time are linked to a higher risk of retinopathy.

- High blood pressure. Uncontrolled high blood pressure further damages blood vessels in the retina.

- High cholesterol levels. Abnormal cholesterol levels, especially high LDL "bad" cholesterol, increase the risk.

- Pregnancy. Diabetic retinopathy may worsen more quickly in women with diabetes who become pregnant.

Stages of Diabetic Retinopathy

Diabetic Retinopathy progresses through different stages, from mild nonproliferative retinopathy to more advanced proliferative stages.

At the earliest stage, nonproliferative retinopathy involves microaneurysms and small hemorrhages. If blood vessels continue to be damaged, more severe nonproliferative changes occur like venous beading, arterial narrowing, and cotton-wool spots.

Eventually, proliferative changes emerge as the retina attempts compensatory new blood vessel growth. Unfortunately, these new vessels are fragile and prone to bleeding. Scarring and retinal detachment may follow, destroying vision. Proliferative retinopathy represents an advanced stage where vision loss is more likely without prompt treatment.

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