Table of ContentsView AllTable of ContentsNPDR vs. PDRSymptomsCausesDiagnosisTreatmentPrognosisComplicationsFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
NPDR vs. PDR
Symptoms
Causes
Diagnosis
Treatment
Prognosis
Complications
Frequently Asked Questions
Proliferative diabetic retinopathy (PDR) is the advanced stage ofdiabetic retinopathy, an eye disease related todiabetes(a condition in which blood sugar levels are high). In proliferative diabetic retinopathy, new blood vessels grow in theretina, the light-sensing layer at the back of the eye. It’s a serious condition and can lead to vision loss.
Taking precautions before you reach this stage of diabetic retinopathy is essential to prevent this potentially sight-threatening condition.
This article will highlight how proliferative diabetic retinopathy differs from non-proliferative diabetic retinopathy (NPDR), the symptoms and causes, how it is diagnosed and treated, and what to know about your prognosis and possible complications.
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There are two forms of diabetic retinopathy: non-proliferative diabetic retinopathy or proliferative diabetic retinopathy.
Diabetic retinopathy can also cause some blood vessels to shut down. When there isn’t enough blood supply to the retina, a signal is sent out that spurs the development of new blood vessels. But these are abnormal and prone to leaking. This advanced stage, where such blood vessels develop, is known as PDR.
The bleeding from these abnormal new vessels can lead to scarring on the retina. Ultimately, the scarring can lead toretinal detachment, in which the retina separates from the back of the eye. In turn, this can lead to vision loss.
Abnormal new vessels can also grow in the front of the eye and block the normal drainage of fluid, leading to elevated eye pressure (neovascular glaucoma). Elevated eye pressure can then cause permanent damage to the optic nerve, which can also contribute to permanent vision loss.
Preventing PDR
Preventing proliferative diabetic retinopathy centers on getting diabetes under control and monitoring your eyes for the progression of diabetic retinopathy.
It can help to take the following measures:
With diabetic retinopathy, early on, you will likely have no symptoms. However, that will change over time. Symptoms you may develop as the disease progresses include:
Diabetic Retinopathy
Intype 1 diabetes,type 2 diabetes, andgestational diabetes, high blood sugar damages the small blood vessels in your eye and throughout the body. This can lead to blockage of the blood vessels and leaking.
Proliferative diabetic retinopathy occurs if your retina is not receiving enough blood due to blocked blood vessels. This sends signals for new blood vessels to develop on its surface. However, these new blood vessels tend to be delicate (with thin walls) and leak.
When these blood vessels leak, they can cause scarring and lead to severe vision loss or blindness.
To examine your eyes for proliferative diabetic retinopathy, your eye care provider will dilate (expand) your pupil at the center of your eye. This enables them to see the structures inside your eye,
To observe changes in your retinal blood vessels, they will perform fluorescein angiography. They will inject a yellow dye (fluorescein) into a vein (probably in your arm). They will take images of the retinal blood vessels using a special camera. This will show if blood vessels are leaking and whether new abnormal blood vessels are forming.
The eye care provider may also do fluorescein angiography to check if the retina is swollen and to measure it.
A newer type of angiography, optical coherence tomography (OCT) angiography is a noninvasive technology that provides three-dimensional imaging of the retinal blood vessels and structures. It can measure the swelling of the macula in the retina.
If you have proliferative diabetic retinopathy, you should be under the care of anophthalmologist(physician specializing in eye health) who is experienced in treating this condition. Treatments may include the following:
Your outcome with PDR will depend on the condition of your retina. Those who receive treatment before severe damage is done to the retina have a good chance of keeping their vision. So, it is important that you get frequent checkups to make sure that your proliferative diabetic retinopathy remains under control.
One complication to be concerned about with PDR is retinal scarring, which can occur when blood leaks onto the area from abnormal blood vessels. These scars can shrink and tug on the retina, distorting vision.
If they tug hard enough, they can cause a retinal detachment, when the light-sensitive retina pulls away from the back of the eye. A retinal detachment is extremely serious. If this is not promptly treated, vision loss can be permanent.
High blood sugar can also contribute to the formation of acataract, in which the clear lens of the eye becomes clouded. Neovascular glaucoma can also develop. This can damage the optic nerve and lead to vision loss.
Summary
Those with proliferative diabetic retinopathy are in the more advanced stage of the disease. The difference between the proliferative and non-proliferative stages is that abnormal new blood vessels have begun forming on the retina in this more advanced stage.
This occurs when regular blood vessels begin to close off due to high sugar levels. In turn, the retina sends a signal for new blood vessels to develop. Such new blood vessels can be seen with diagnostic techniques such as fluorescein angiography.
Treatments for proliferative diabetic retinopathy include laser photocoagulation, anti-VEGF injections, and sometimes the removal of the vitreous gel.
A Word From Verywell
Proliferative diabetic retinopathy is a serious condition. But if this is promptly treated before damage to the retina has had a chance to occur, this condition can be managed and sight maintained. See an eye care specialist as soon as you notice vision changes.
While there is no cure for proliferative diabetic retinopathy, treatment can slow down and even prevent vision loss. The sooner you start treatment, the better your chances are of preserving your vision.Learn MoreDiabetic Retinopathy Treatment
While there is no cure for proliferative diabetic retinopathy, treatment can slow down and even prevent vision loss. The sooner you start treatment, the better your chances are of preserving your vision.
Learn MoreDiabetic Retinopathy Treatment
Learn MoreDiabetic Retinopathy Symptoms and Stages
Learn MoreBlurred Vision in Diabetes
7 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Academy of Ophthalmology.Diabetic retinopathy, causes, symptoms, treatment.National Eye Institute.Diabetic retinopathy.Johns Hopkins Medicine.Diabetic retinopathy,University of Chicago Medicine.Diabetic retinopathy.Stanford Medicine.Diabetic retinopathy treatment.American Diabetes Association.Eye complications.American Academy of Ophthalmology.Diabetic eye disease.
7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Academy of Ophthalmology.Diabetic retinopathy, causes, symptoms, treatment.National Eye Institute.Diabetic retinopathy.Johns Hopkins Medicine.Diabetic retinopathy,University of Chicago Medicine.Diabetic retinopathy.Stanford Medicine.Diabetic retinopathy treatment.American Diabetes Association.Eye complications.American Academy of Ophthalmology.Diabetic eye disease.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Academy of Ophthalmology.Diabetic retinopathy, causes, symptoms, treatment.National Eye Institute.Diabetic retinopathy.Johns Hopkins Medicine.Diabetic retinopathy,University of Chicago Medicine.Diabetic retinopathy.Stanford Medicine.Diabetic retinopathy treatment.American Diabetes Association.Eye complications.American Academy of Ophthalmology.Diabetic eye disease.
American Academy of Ophthalmology.Diabetic retinopathy, causes, symptoms, treatment.
National Eye Institute.Diabetic retinopathy.
Johns Hopkins Medicine.Diabetic retinopathy,
University of Chicago Medicine.Diabetic retinopathy.
Stanford Medicine.Diabetic retinopathy treatment.
American Diabetes Association.Eye complications.
American Academy of Ophthalmology.Diabetic eye disease.
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