What is the nature of the changes that occur during diabetic retinopathy?

Diabetic retinopathy primarily involves microvascular changes that lead to ischemia within the retinal tissue. This condition arises due to prolonged hyperglycemia, which causes damage to the small blood vessels in the retina. Over time, these microvascular lesions can lead to leakage of fluid and proteins, increased permeability of the blood-retinal barrier, and occlusion of retinal capillaries. As a result, ischemia occurs, meaning that certain areas of the retina do not receive adequate blood supply, which can lead to vision impairment and even retinal detachment in more advanced stages.

The changes can be categorized into two main stages: non-proliferative diabetic retinopathy (NPDR), where there's a buildup of retinal microaneurysms, retinal hemorrhages, and exudates, and proliferative diabetic retinopathy (PDR), characterized by the formation of new, abnormal blood vessels that can lead to bleeding and scarring. The underlying microvascular damage is a crucial feature of the disease.

Other options, such as necrotic and inflammatory changes, severe degenerative changes of the optic nerve, and increased intraocular pressure leading to glaucoma, do not accurately describe the specific pathological events occurring in diabetic retinopathy. The condition is