Eye health resource
Can Diabetic Retinopathy Be Reversed?
Some diabetic-retinopathy changes can improve with treatment, but permanent vision already lost from retinal damage may not return. Learn about monitoring and specialist treatment.
Reviewed for accuracy by Justin Bazan, OD on .
The answer depends on what you mean by “reversed.” Some diabetic-retinopathy changes can improve with treatment, and anti-VEGF therapy can reduce the severity of retinopathy in some patients. But vision already lost from permanent retinal damage may not return.
Better diabetes management and appropriate eye treatment can slow or stop progression, and treatment can improve vision in some patients—especially when diabetic macular edema is contributing to the blur. The earlier diabetic retinal disease is detected, the more opportunity there is to protect useful vision before advanced complications occur.
What Is Diabetic Retinopathy?
Diabetic retinopathy is damage to the retinal blood vessels caused by diabetes. It can occur in people with type 1 or type 2 diabetes and may be present before vision noticeably changes.
Early stages are called nonproliferative diabetic retinopathy (NPDR). As disease becomes more severe, retinal blood vessels can leak or close. In proliferative diabetic retinopathy (PDR), abnormal new blood vessels grow and can bleed or create scar tissue that threatens the retina.
What Is Diabetic Macular Edema?
Diabetic macular edema, often abbreviated DME, occurs when leaking retinal blood vessels cause swelling in the macula—the part of the retina responsible for detailed central vision.
DME can occur at different stages of diabetic retinopathy and is an important reason treatment may sometimes improve vision rather than simply prevent additional loss.
Can Better Blood Sugar Control Reverse the Retinopathy?
Good control of blood glucose, blood pressure, and cholesterol can reduce the risk of diabetic retinopathy developing or worsening. These measures are central to long-term retinal health.
That does not mean established retinal damage will reliably disappear or lost vision will automatically return when blood sugar improves. Medical management is about reducing future damage as well as supporting overall health.
How Is Diabetic Retinopathy Treated?
Treatment depends on the severity and whether macular edema, new blood vessels, bleeding, scar tissue, or other complications are present.
Anti-VEGF Injections
Retina specialists commonly use medications injected into the eye to reduce abnormal blood-vessel signaling and retinal swelling. Anti-VEGF treatment can slow progression, reduce the severity of diabetic retinopathy in some patients, and improve vision in some patients with diabetic macular edema or proliferative disease.
Retinal Laser Treatment
Laser photocoagulation may be used in selected cases to treat leaking areas or reduce the risk from abnormal retinal blood vessels. This is retinal laser treatment—not LASIK or the refractive laser surgery used to reduce dependence on glasses.
Vitrectomy
Vitrectomy is eye surgery that may be needed when there is significant vitreous hemorrhage, traction, scar tissue, or retinal detachment related to advanced diabetic eye disease.
These injections, retinal laser procedures, and surgeries are performed by ophthalmologists/retina specialists rather than as routine treatment at Park Slope Eye.
What Is Park Slope Eye's Role?
Park Slope Eye provides medical eye care and can evaluate the retina, document findings with appropriate imaging, monitor selected eye-health findings within the practice's scope, and refer to ophthalmology or a retina specialist when treatment or specialist monitoring is needed.
Optos wide-angle retinal imaging and OCT can provide useful retinal documentation, but they do not replace dilation or specialist testing in every diabetic patient. The examination method should match the patient's findings and risk.
How Often Should Someone With Diabetes Have an Eye Exam?
People with diabetes need regular dilated retinal evaluation, but the exact timing is individualized. Diabetes type, duration, pregnancy, blood-sugar control, previous retinal findings, and any active diabetic retinopathy can change how often follow-up is needed.
Someone with established diabetic retinopathy may need examinations much more frequently than someone with no retinal disease.
What Symptoms Can Diabetic Retinopathy Cause?
Early diabetic retinopathy may cause no symptoms. As disease advances, symptoms can include:
- blurred or fluctuating vision
- new floaters
- dark or missing areas of vision
- difficulty with detailed central vision
- significant vision loss in advanced disease
A sudden shower of floaters, new flashes, a curtain or shadow, or sudden major vision loss requires urgent evaluation because those symptoms can also signal bleeding or retinal detachment.
Can Treatment Improve Vision?
Sometimes. For example, reducing macular edema can improve central vision in selected patients. But treatment cannot guarantee restoration of vision that has been permanently lost from retinal ischemia, scarring, or other advanced damage.
The goals are to preserve as much vision as possible, treat reversible components when available, and reduce the chance of further damage.
Protect Your Vision With Diabetes
Do not wait for symptoms before having your retina evaluated. If you have diabetes and are due for eye care, book an appointment at Park Slope Eye. If specialist retinal treatment is needed, we can help identify that need and coordinate the appropriate referral.
Originally published . Substantially updated .