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Normal retinal blood vessels are watertight and do not leak. In diabetes, the retinal blood vessels can become damaged and develop tiny leaks. This is called nonproliferative diabetic retinopathy (NPDR). Blood and fluid seep from the leaks in the damaged retinal blood vessels, and fatty material (called exudate) can deposit in the retina. This causes swelling of the retina. When leakage occurs and causes swelling in the central part of the retina (the macula), it is called macular edema, and vision will be reduced or blurred.
Over time, too much sugar in your blood can lead to the blockage of the tiny blood vessels that nourish the retina, cutting off its blood supply. As a result, the eye attempts to grow new blood vessels. But these new blood vessels don't develop properly and can leak easily. There are two types of diabetic retinopathy: Early diabetic retinopathy. In this more common form â called nonproliferative diabetic retinopathy (NPDR) â new blood vessels aren't growing (proliferating). When you have NPDR, the walls of the blood vessels in your retina weaken. Tiny bulges (microaneurysms) protrude from the vessel walls of the smaller vessels, sometimes leaking fluid and blood into the retina. Larger retinal vessels can begin to dilate and become irregular in diameter, as well.