The first pathological change occurs in the smallest retinal blood vessels called “capillaries”. This is where oxygen exchange occurs. The capillary wall develops a weakness and results in a bulge called a “microaneurysm”. Plasma leaks and bleeding can occur. This stage is called background retinopathy. If this occurs at the center of the retina, it is called maculopathy and vision is reduced.

With progressive disease the oxygen supply to the retina is diminished. New abnormal blood vessels are stimulated by the retina to form. This stage is called proliferative retinopathy. These vessels are very fragile, can bleed and cause retinal detachment.

Dr. Matzkin can diagnose diabetic retinopathy with a clinical exam, photographs and a fluorescein angiogram where a dye injected into the vein can highlight leaking and abnormal retinal blood vessels.