Diabetes also referred to as diabetes mellitus, has become a global epidemic affecting an estimated 8.5% of the world’s population, and is expected to rise to around 10% by 2040.

Preventing, managing, and treating complications related to diabetes is key to reducing the impact of the disease on individuals, families, and society. Blindness is one such complication, and new research is challenging previous assumptions about the causes of diabetes-related blindness.

The Connection Between Diabetes and Blindness

Diabetic retinopathy is a condition that develops in people with diabetes, resulting from damage to blood vessels in the retina, the layer of tissue at the back of the eye responsible for processing light into images.

Over time, high blood sugar levels damage the tiny blood vessels that provide oxygen and nutrients to the retina, causing them to leak fluid and blood into the surrounding tissue.

Leaking blood vessels cause swelling and affect the normal function of the retina, leading to vision loss. Initially, people with diabetic retinopathy may not experience any symptoms, and the condition may progress slowly over time.

However, if left untreated, it can lead to blindness.

Current Treatments for Diabetic Retinopathy

The onset of diabetic retinopathy usually occurs ten to fifteen years after the onset of diabetes, and the disease progresses with time.

Keeping blood sugar levels within the recommended range, eating a healthy diet, and getting regular exercise can help prevent or delay the onset of diabetic retinopathy. If detected early, diabetic retinopathy can be treated with laser therapy or surgery. For more advanced cases, medications such as anti-VEGF injections may be used to slow the progression of the disease.

Rather than just being a result of damage to blood vessels, new research suggests that diabetic retinopathy might be primarily caused by damage to neural tissue in the retina.

Studies conducted at the Schepens Eye Research Institute of Massachusetts Eye and Ear and Harvard Medical School have found that high blood sugar levels cause immune cells in the retina to release cytokines, which trigger inflammation and damage to retinal neurons. This neuronal damage leads to a breakdown in communication between the retina and the brain, resulting in vision loss.

This discovery challenges the previous assumption that abnormal blood vessel growth, as seen in diabetic retinopathy, is the leading cause of vision loss in people with diabetes.

Instead, the findings show that inflammation and damage to neural tissue in the retina play a more significant role in diabetic retinopathy.

What this Means for Future Treatments

This research is paving the way for new therapies and treatments for diabetic retinopathy that target inflammation and neural damage rather than just abnormal blood vessel growth.

Current treatments to stop the progression of the disease only target the blood vessels themselves, but the new findings suggest that treatments that target inflammation and neural damage may be more effective at slowing the progression of the disease and preventing vision loss.

In addition, the findings open up opportunities for early interventions, such as anti-inflammatory drugs or nerve growth factors, that could prevent or reduce the damage to neural tissue in the retina before vision loss occurs.

The Importance of Early Detection

Early detection and management of diabetic retinopathy are vital in preventing or reducing the severity of vision loss.

Since diabetic retinopathy can be symptomless in its early stages, regular eye exams are essential for people with diabetes to detect any problems early on. The American Optometric Association (AOA) recommends that people with diabetes get a comprehensive eye exam at least once a year, and more often if they have signs of diabetic retinopathy or other eye problems.

Conclusion

Diabetic retinopathy is a leading cause of blindness, and its progression and impacts on vision have been widely attributed to damage to blood vessels in the retina.

However, new research is challenging this understanding, revealing that inflammation and neural damage in the retina might be the primary cause of the condition.

These findings open up new opportunities for research and novel treatments that target inflammation and neural damage rather than just abnormal blood vessel growth, giving hope to the millions of people affected by diabetes-related blindness worldwide.