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Proliferative Diabetic Retinopathy

Diabetic retinopathy occurs when high blood sugar levels cause damage to blood vessels in the retina. Diabetic retinopathy can progress to this more severe type, known as proliferative diabetic retinopathy when damaged blood vessels get blocked and new, abnormal blood vessels grow in the retina.

Symptoms of Proliferative Diabetic Retinopathy

The symptoms of proliferative diabetic retinopathy include

  • blurred vision/loss of vision

  • seeing floaters or dark spots

  • Pain, redness

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:

    Pregnant women face a higher risk for developing diabetes and diabetic retinopathy.

  • Heredity

  • Sedentary lifestyle

  • Diet

  • Obesity


Proliferative Diabetic Retinopathy Prevention

You can’t always prevent diabetic retinopathy. 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.

  • Stop smoking

  • Regular exercise

  • Timely treatment and appropriate follow ups are important.

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.

Proliferative Diabetic Retinopathy Diagnosis

Visual acuity testing:

This eye chart test measures a person’s vision


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 and new 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.

B Scan Ultrasonography:

It uses ultrasound waves to image the eye when there is no view of the retina due to vitreous haemorrhage.


Proliferative Diabetic Retinopathy Complications

  • Vitreous hemorrhage. The new blood vessels are fragile and may bleed into the eye. If the amount of bleeding is small, you might see only a few floaters. In severe cases, blood can fill the eye and cause reduced vision.

  • Retinal detachment. The abnormal blood vessels can form scar tissue which can pull on the retina and cause retinal detachment.

  • New blood vessels may grow in the front part of your eye and invade the drainage part of the eye, causing increased pressure in the eye. This pressure can damage the nerve that carries images from your eye to your brain .

  • Eventually, diabetic retinopathy, glaucoma or both can lead to complete vision loss.


Proliferative Diabetic Retinopathy Treatment

The goal of any treatment is to slow or stop the progression of the disease. Diet and exercise and controlling blood sugar levels can help control the progression of the disease.

Laser :

 Widespread blood vessel growth in the retina, which occurs in proliferative diabetic retinopathy, can be treated by creating a pattern of scattered laser burns across the retina. This causes abnormal blood vessels to shrink and disappear. With this procedure, some side vision may be lost in order to safeguard central vision.

Medical management:

Injection of anti VEGF medication into the eye may be used in selected patients with bleeding into the eye.

Surgical management:

Vitrectomy involves removing scar tissue and blood from the vitreous fluid of the eye.


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

Frequently Asked Questions (FAQs)

What is proliferative diabetic retinopathy (PDR)?

Proliferative diabetic retinopathy (PDR) is an advanced stage of diabetic retinopathy, a condition that affects the eyes of individuals with diabetes. In PDR, abnormal blood vessels begin to grow on the surface of the retina, the light-sensitive tissue at the back of the eye.

Symptoms of proliferative diabetic retinopathy may include blurred or distorted vision, floaters (spots or dark strings) in the vision, sudden loss of vision, or difficulty seeing colors.

Proliferative diabetic retinopathy develops in individuals with diabetes due to long-term damage to blood vessels in the retina caused by high blood sugar levels. This damage triggers the growth of abnormal blood vessels as the body attempts to compensate for reduced blood flow to the retina.

Proliferative diabetic retinopathy is distinguished from other stages of diabetic retinopathy by the presence of new, fragile blood vessels on the retina’s surface. These vessels can leak blood into the eye, leading to vision loss and other complications if left untreated.

Risk factors associated with the development of proliferative diabetic retinopathy include poorly controlled blood sugar levels, high blood pressure, high cholesterol, long duration of diabetes, and pregnancy in women with diabetes.

At Dr Agarwals Eye Hospital, treatment options for proliferative diabetic retinopathy may include laser photocoagulation therapy, intravitreal injections of anti-VEGF drugs, vitrectomy (surgical removal of vitreous gel from the eye), or a combination of these treatments depending on the severity and individual needs of the patient. It’s important for individuals with diabetes to undergo regular eye examinations to detect and manage diabetic retinopathy early to prevent progression to proliferative diabetic retinopathy.


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