What is Diabetic Retinopathy?

Diabetic retinopathy is a serious complication of long-term uncontrolled diabetes resulting from persistently high blood sugar levels over the years. This condition affects the retina, the light-sensitive tissue at the back of the eye, impairing its ability to transmit clear images to the brain through the optic nerve.

At Moorfields Eye Hospitals, our retina specialists in Dubai and Abu Dhabi have extensive sub-speciality training in the diagnosis and treatment of diabetic retinopathy. Using the latest retinal imaging and advanced therapeutic techniques, they provide tailored care to slow disease progression, protect sight, and support patients in maintaining their long-term eye health and quality of life.

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What are the different types of Diabetic Retinopathy?

  • Non-Proliferative Diabetic Retinopathy: In its initial stages, NPDR often presents with minimal symptoms. The retina may show only slight changes, such as a few enlarged blood vessels, minor bleeding, or leakage. These subtle signs are typically identified during a comprehensive retinal examination by an ophthalmologist.
  • Proliferative Diabetic Retinopathy: As the condition progresses, abnormal new blood vessels may form on the retina. These vessels are prone to bleeding, significantly impairing vision and potentially leading to retinal detachment. Laser treatment is frequently employed to prevent severe, long-term damage.
  • Diabetic Maculopathy: This occurs when leakage from blood vessels causes swelling in the macula, severely affecting vision. Treatment options may include laser therapy, intravitreal injections, or surgery to manage the swelling and prevent further damage.

Symptoms of Diabetic Retinopathy

Early detection is key to effective management. Patients should be aware of symptoms that may include:

  • Spots or dark strings floating in your vision (floaters)
  • Blurred vision
  • Fluctuating vision
  • Impaired colour vision
  • Dark or empty areas in your vision
  • Vision loss

Causes of Diabetic Retinopathy

Diabetic retinopathy is most common in individuals who have lived with diabetes for an extended period, mainly when blood sugar levels are not well controlled. This condition affects approximately 8 out of 10 patients with a 10 or more years of diabetes who experience some form of this eye condition. Damage to the retinal blood vessels is at the heart of the disease’s progression.

How does the Diabetic Retinopathy develop?

The retina relies on a network of blood vessels to supply essential oxygen and nutrients. Over time, consistently elevated blood sugar levels can damage these vessels, causing them to bleed, leak, or become blocked. This damage may lead to various forms of retinal impairment, including developing new, fragile blood vessels that can burst, resulting in blurred or lost vision. When the central area of the retina, known as the macula, is affected, the condition is known as Diabetic Maculopathy, a sign of more advanced disease. The risk of retinal damage increases significantly when high blood pressure is also present.

Diabetic retinopathy may be present even when vision appears normal. Comprehensive eye examinations by an ophthalmologist are crucial, often incorporating:

  • Fundus Examination: A detailed evaluation of the retina.
  • Optical Coherence Tomography (OCT): Imaging to assess retinal thickness and swelling.
  • Fluorescein Angiography: A test to visualise the blood vessels in the retina and determine the extent of leakage or blockage.

A range of treatment options is available for diabetic retinopathy, and sometimes a combination of treatments is used. These may include:

  • Intravitreal injections of medications (anti-VEGF and/or steroids): Medications such as anti-VEGF drugs help reduce abnormal blood vessel growth and leakage, while steroids diminish macular swelling.
  • Laser therapy: Lasers improve oxygen delivery to the retina and reduce the stimulus for the growth of new, abnormal blood vessels.
  • Surgery: In advanced cases, surgical intervention may be necessary to remove non-clearing hemorrhages and fibrotic tissue that can lead to retinal detachment.

Tips for prevention: 

  • Maintain blood sugar levels: Consistently managing blood sugar prevents diabetic retinopathy. Regular monitoring and adhering to your diabetes management plan can significantly reduce the risk.
  • Eat a healthy diet: A balanced diet of fruits, vegetables, whole grains, and lean proteins helps maintain blood sugar levels and overall eye health. Avoiding excessive sugar and processed foods can prevent complications.
  • Exercise regularly: Regular physical activity helps control blood sugar levels, blood pressure, and cholesterol, which are essential in reducing the risk of exacerbating diabetic retinopathy.
  • Routine visits to ophthalmologist: Regular eye exams are essential for early detection of diabetic retinopathy. Early diagnosis allows for timely treatment and better management of the condition.
  • Manage Blood Pressure and Cholesterol: High blood pressure and cholesterol levels can exacerbate diabetic retinopathy. If necessary, monitoring and managing these factors through lifestyle changes and medication can help prevent retinal damage.

Early diagnosis of diabetes-related vision problems typically leads to better management and improved outcomes, making regular eye screenings important.

Diabetic Retinopathy Specialists

FAQ

Diabetes is one of the most common health conditions in the UAE, affecting approximately 20.7% of adults (https://diabetesatlas.org/data-by-location/country/united-arab-emirates/).
That prevalence matters for eye health because diabetes can damage the retina, and around one in three people living with diabetes will develop some form of diabetes-related eye complication during their lifetime. The most common is diabetic retinopathy, which often progresses without symptoms until it begins to affect vision. Diabetes can also increase the risk of other eye conditions, including diabetic macular oedema, cataract, and glaucoma.

Children and teenagers living with diabetes can develop diabetic retinopathy, although it is less common than in adults and rarely affects vision in the early years after diagnosis. The risk increases over time, particularly when blood sugar levels are difficult to manage or when diabetes has been present for several years.
Because diabetic retinopathy usually develops without any noticeable symptoms in its early stages, regular eye examinations are an important part of long-term care for young people with diabetes. Our specialised paediatric ophthalmologists will recommend how often eye examinations should be repeated, based on your child’s age, how long they have had diabetes, how well their blood sugar is managed, and any other individual risk factors.

Family history can increase your risk of developing diabetes. Diabetic retinopathy only becomes a risk if you have diabetes, and the risk is influenced by factors such as how long you have had diabetes, blood sugar control, blood pressure and cholesterol levels.
If a close relative with diabetes has developed diabetic retinopathy, especially at a younger age or in a more advanced form, it is worth mentioning this during your eye examination. Our retina specialists can use this information, together with your retinal findings and medical history, to recommend the right monitoring schedule..

Most people living with diabetes are advised to have a comprehensive diabetic eye examination at least once a year. Some patients may need more frequent monitoring, particularly if diabetic retinopathy has been detected, if there are changes in vision, or if blood sugar or blood pressure control has changed. Our retina specialists will recommend the right follow-up schedule based on your diabetes history, retinal findings and individual risk factors.

Keeping blood sugar levels well managed can help reduce the risk of diabetic retinopathy developing or worsening. Blood pressure and cholesterol control are also important, as these affect the health of the small blood vessels in the retina.
Diabetes management is one part of protecting long-term eye health, but it does not replace a detailed retinal assessment. Our retina specialists work in close coordination with endocrinologists and other specialists in systemic diseases to ensure patients with diabetes receive joined-up care.

Diabetes can affect the small blood vessels in the retina before you notice any change in your vision. This is why diabetic retinopathy is often detected during a retinal examination rather than through symptoms alone. When symptoms do develop, they may include blurred or fluctuating vision, floaters, changes in colour vision, dark or empty areas in your vision, and, in more advanced cases, vision loss. If you notice any of these changes, you should arrange an eye assessment, even if your last examination was recent.

Diabetic retinopathy cannot always be fully reversed, particularly if the retina has already been permanently damaged. However, early detection, good diabetes control and timely treatment can help slow its progression and reduce the risk of further sight loss. Treatment depends on the stage of the condition and whether the macula (the central part of the retina responsible for sharp, detailed vision) is affected. In some patients, diabetes can cause fluid to build up in this area, known as diabetic macular oedema, which can affect central vision. Our retina specialists will assess the extent of the condition using retinal imaging and recommend the most appropriate management plan, which may include monitoring, eye injections, laser treatment or surgery.

If diabetic retinopathy is not monitored or treated when needed, it can progress and become sight-threatening. Over time, damage to the retinal blood vessels can cause swelling in the macula, bleeding inside the eye, and the growth of fragile new blood vessels. In more advanced cases, this can lead to tractional retinal detachment, neovascular glaucoma or permanent vision loss. Your ophthalmologist will assess the stage of the condition and recommend the most appropriate next step, whether this is closer monitoring, eye injections, laser treatment or surgery.

Diabetic retinopathy care at Moorfields Eye Hospitals UAE is led by our retina specialists in Dubai and Abu Dhabi, who have extensive experience in diagnosing and managing diabetes-related eye conditions. Treatment is delivered through clinical protocols and governance processes aligned with JCI and ACHSI standards, as well as the established standards of Moorfields Eye Hospital London, all of which support a consistent approach to quality, safety and patient care. To view the full team, visit moorfields.ae/departments/ophthalmologists/.

Moorfields Eye Hospitals UAE works with a wide range of insurance providers across the UAE. Coverage for diabetic retinopathy consultations, investigations or treatment depends on your individual policy and any approval requirements. Patients are encouraged to check with their insurer or contact Moorfields UAE to confirm their cover before their appointment.
The full list of accepted insurance providers is available at www.moorfields.ae/insurance-provider/.

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