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Non Proliferative Diabetic Retinopathy

People with diabetes can have an eye disease called diabetic retinopathy. This is when high blood sugar levels cause damage to blood vessels in the retina. Diabetic retinopathy affects up to 80 percent of those who have had diabetes for 20 years or more. At least 90% of new cases could be reduced with proper treatment and monitoring of the eyes.

Symptoms of Non Proliferative Diabetic Retinopathy

The symptoms of diabetic retinopathy often don’t appear until major damage occurs inside of the eye. They include

  • Blurred vision/ loss of vision

  • Seeing floaters or dark spots

  • Difficulty seeing at night

  • Difficulty distinguishing colors

Non Proliferative Diabetic Retinopathy Risk Factors

  • Diabetes: The longer a person has diabetes, the more likely he or she is to develop diabetic retinopathy, particularly if the diabetes is poorly controlled.

  • Medical conditions: other medical conditions like high blood pressure and high cholesterol increase the risk

  • Pregnancy

  • Heredity

  • Sedentary lifestyle

  • Diet

Stages of Non Proliferative Diabetic Retinopathy

Mild non proliferative diabetic retinopathy – swelling in small areas of the blood vessels in the retina.

Moderate non proliferative diabetic retinopathy – some of the blood vessels in the retina will become blocked leading to hemorrhages

Severe non proliferative diabetic retinopathy – more blocked blood vessels, which lead to areas of the retina no longer receiving adequate blood flow

Diagnosis of Non Proliferative Diabetic Retinopathy

Visual acuity testing: This measures a person’s vision.

Tonometry: This test measures pressure inside the eye.

Pupil dilation: Drops placed on the eye’s surface widen the pupil, allowing a physician to examine the retina and optic nerve.

Comprehensive dilated eye exam:

It allows the doctor to check the retina for:

  • Changes to blood vessels or leaking blood vessels
  • Fatty deposits
  • Swelling of the macula (Diabetic macular edema)
  • Changes in the lens
  • Damage to nerve tissue

Optical coherence tomography (OCT):

It uses light waves to produce images of the retina to assess the amount of fluid.

Fundus fluorescein angiography(FFA):

During this test, your doctor will inject a dye into your arm, allowing them to track how the blood flows in your eye. They’ll take pictures of the dye circulating inside of your eye to determine which vessels are blocked, leaking, or broken.

Non Proliferative Diabetic Retinopathy Treatment 

The goal of any treatment is to slow or stop the progression of the disease. In the early stages of non-proliferative diabetic retinopathy, regular monitoring may be the only treatment. Diet and exercise and controlling blood sugar levels can help control the progression of the disease.

Laser : If the disease advances, the blood vessels can leak blood and fluid into the retina, leading to macular edema. Laser treatment can stop this leakage. Focal laser photocoagulation involves using a laser to target a specific leaky vessel in the macula to keep macular edema from worsening.


If you are  diagnosed  with diabetes, it is important to do the following:

  • Get regular eye exams and physical checkups.

  • Keep your blood sugar, cholesterol, and blood pressure at healthy levels.

  • Be mindful of any changes you may notice in your vision, and discuss them with your doctor.

  • Timely treatment and appropriate follow ups are important

  • Regular exercise

If you or someone close to you has developed diabetic retinopathy, do not put off an eye test. Walk into Dr. Agarwal’s Eye Hospital for an appointment with top specialists and surgeons in the field of eye care.


Written by: Dr. Preetha Rajasekaran – Consultant Ophthalmologist, Porur

Frequently Asked Questions (FAQs)

What is non-proliferative diabetic retinopathy (NPDR)?

Non-proliferative diabetic retinopathy (NPDR) is an early stage of diabetic retinopathy, where blood vessels in the retina become damaged due to high blood sugar levels.

Early signs and symptoms include blurred vision, difficulty seeing at night, floaters, and mild vision loss. However, NPDR may not always cause noticeable symptoms in the early stages.

NPDR can progress over time, leading to leakage of fluid and blood into the retina, swelling, and thickening of the retina. If untreated, it can lead to vision problems and even blindness.

Factors contributing to NPDR include high blood sugar levels, long duration of diabetes, high blood pressure, high cholesterol, smoking, pregnancy, and genetics.

While NPDR cannot always be prevented, controlling blood sugar, blood pressure, cholesterol, quitting smoking, and regular eye exams can help reduce the risk or delay its progression.

Treatment options at Dr Agarwals Eye Hospital include laser therapy, intravitreal injections of anti-VEGF drugs or corticosteroids, and vitrectomy surgery, depending on the severity and individual patient needs. It’s highly recommended to consult your doctor before you take any decision.


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