There are different types of retinopathy: background retinopathy, maculopathy and proliferative retinopathy. These are summarised in the introduction to this section, but below is more detailed explanation about the conditions.
Background retinopathy
(also called non-proliferative retinopathy)
The earliest visible change to the retina is known as background retinopathy.
The capillaries (small blood vessels) in the retina become blocked, they may bulge slightly (microaneurysm) and may leak blood (haemorrhages) or fluid (exudates).
This type of retinopathy will not affect your eyesight, but it needs to be carefully monitored by your GP, diabetologist or eye specialist. Your annual screening test will keep a close check on these early changes and make sure that any signs that there could be a progression to more serious stages of retinopathy are detected early, and treated appropriately.
Maculopathy
The macula is the most used area of the retina. It provides our central vision and is essential for clear, detailed vision.
If the background retinopathy (see above) is at or around the macula, the fluid leaking from the enlarged blood vessels builds up and causes swelling (oedema).
This can lead to some loss of vision, particularly for reading and seeing fine details, and everything may appear blurred, as if you are looking through a layer of fluid not quite as clear as water.
Maculopathy is more common in people with Type 2 diabetes and if left untreated can cause blindness.
Information on laser and Anti-VEGF medications (intra-ocular injection) treatment.
People who have advanced maculopathy or haemorrhages (see proliferative retinopathy, below) may need to consider registering as blind or partially sighted. Your eye specialist and other professionals such as a social worker or rehabilitation officer will be able to help.
Proliferative (spreading) retinopathy
As background retinopathy develops, large areas of the retina are deprived of a proper blood supply because of blocked and damaged blood vessels. This stimulates the growth of new blood vessels to replace the blocked ones. These growing blood vessels are very delicate and bleed easily. The bleeding (haemorrhage) causes scar tissue that starts to shrink and pull on the retina leading to it becoming detached and causing blindness.
Only between 5 and 10 per cent of all people with diabetes develop proliferative retinopathy. It is more common in people with Type 1 diabetes. Sixty per cent of people with Type 1 diabetes show some signs of proliferative disease after having diabetes for 30 years.
People who have early or moderate proliferative retinopathy should be referred for laser treatment.
Reviewed March 2011
Next review September 2012