What Is Diabetic Retinopathy and Its Scale
Diabetic retinopathy (DR) is a vision-threatening microvascular complication of diabetes mellitus that affects the retina of the eye [5]. According to statistics, about 93 million people worldwide suffer from this disease, and it remains one of the leading causes of irreversible vision loss [5]. Retinal vascular damage is divided into non-proliferative and proliferative stages, often accompanied by macular edema threatening central vision [6].
The medical care cascade for diabetic retinopathy includes timely diabetes diagnosis, regular fundus screening, adequate treatment, and blindness prevention [1]. Unfortunately, due to gaps in the healthcare system, many patients lose their vision from preventable causes [1].
Main Symptoms and Stages of Pathology Development
In the early stages, the disease can be completely asymptomatic. That is why it is vital for patients with diabetes mellitus to undergo regular check-ups with an ophthalmologist. As the process progresses, the following signs appear:
- Decreased visual acuity and blurred vision.
- Appearance of "floaters", dark spots, or floating threads before the eyes.
- Difficulty reading or distinguishing fine details.
- Sharp deterioration of vision with the development of vitreous hemorrhage or macular edema.
According to recent studies, the prevalence of diabetic retinopathy among patients with type 2 diabetes mellitus is about 27.6% [5], which emphasizes the need for continuous monitoring of vascular health.
Risk Factors and Comorbidities
The development and progression of retinopathy are closely linked to the body's overall metabolic status. An important role is played by the level of glycated hemoglobin (HbA1c), the presence of inflammatory processes, and oxidative stress [3]. In addition, scientists have found a link between the severity of retinopathy and cardiovascular pathologies: in particular, the degree of retinal damage correlates with the risks of developing heart failure in patients with type 2 diabetes [4].
Additional risk factors include metabolic disorders. For example, in patients with early-onset diabetes, elevated uric acid levels (hyperuricemia) significantly increase the likelihood of developing retinopathy [8].
Modern Treatment Approaches and New Drugs
Therapy for diabetic retinopathy is aimed at stabilizing the process and preventing blindness. Strict control of blood glucose and blood pressure remains a key factor in success. As medical support, various groups of drugs are being studied, including sodium-glucose cotransporter-2 inhibitors, GLP-1 receptor agonists [7], and tirzepatide [2], which are used for the comprehensive treatment of overweight patients with diabetes mellitus.
To combat macular edema and the proliferative stage, intravitreal injections of anti-VEGF drugs (such as ranibizumab) are actively used, which block the vascular endothelial growth factor—a key driver of DR pathogenesis [6]. Approximately one-third of patients demonstrate clinically significant vision improvement after a year of such therapy [6].
Complications and Prevention of Vision Loss
Without timely intervention, diabetic retinopathy leads to severe complications: hemophthalmos, retinal detachment, neovascular glaucoma, and inevitable blindness [5], [6]. Prevention includes regular retinal screening, maintaining target HbA1c levels, controlling comorbid cardiometabolic risks, and timely correction of glucose-lowering therapy.
Sources
- 1. Diabetic retinopathy treatment cascade and continuity of care in the USA: a systematic review. BMJ Open, 2026.
- 2. Incidence of diabetic retinopathy following one-year tirzepatide therapy in type 1 diabetes. Diabetes Technol Ther, 2026.
- 3. Association between HbA1c and red cell distribution width in type 2 diabetes. BMC Endocr Disord, 2026.
- 4. Diabetic retinopathy severity and heart failure outcomes in type 2 diabetes. J Diabetes, 2026.
- 5. Diabetic retinopathy and associated factors among type 2 diabetes patients. Health Sci Rep, 2026.
- 6. Advances in the management of diabetic retinopathy. J Diabetes Complications, 2019.
- 7. Assessment of diabetic retinopathy progression risk during GLP-1 receptor agonist therapy. BMC Ophthalmol, 2026.
- 8. Age at diabetes onset modifies the association between hyperuricemia and retinopathy. Endocrine, 2026.
Disclaimer: The information is provided for reference purposes only and does not replace an in-person consultation with an ophthalmologist or endocrinologist.