Diabetic retinopathy is a common complication of diabetes mellitus. Due to increased blood glucose, it affects the retinal arterioles and capillaries, resulting in vascular leakage, neovascularization, hemorrhage and proliferative changes, causing visual impairment. Early diagnosis, follow-up and interventional treatment are very important for prognosis. There are two types of diabetic retinopathy: background or non-proliferative diabetic retinopathy (NPDR), which is an early form of diabetic retinopathy and is mainly characterized by retinal vascular leakage, hemorrhage, and sometimes cholesterol or lipid leakage, known as “hard seepage. Mild NPDR mostly does not affect vision, but if it is accompanied by macular edema or macular ischemia, vision may be affected. Proliferative diabetic retinopathy is caused by retinal vascular occlusion, and neovascular growth factor stimulation causes abnormal blood vessels to grow on the surface of the retina or optic disc, resulting in neovascularization, which in turn causes proliferative changes, including scar tissue formation, leading to retinal detachment with traction and severe vision loss. In addition, neovascular glaucoma can form, with increased intraocular pressure, causing severe optic nerve damage. Diagnosis of diabetic retinopathy 1. Blood glucose and vision testing: High blood glucose can cause changes in the shape of the lens and affect vision, which can be restored after blood glucose stabilization. However, if a diabetic patient has vision loss in one or both eyes that lasts for several days it is recommended to see a doctor promptly. Before seeing a doctor, it is important that the blood sugar is stable. If the blood sugar is not stable, it has an impact on the accuracy of some test results, in addition, glycated hemoglobin value is also important. 2, what conditions to do eye examination Age: If the patient is diagnosed with diabetes under 30 years old, need to do eye examination within 1 year. If diabetes is diagnosed after 30 years old, whether there is vision change or not, need to do eye examination within a few months after diagnosis, because at this time diabetic retinopathy may already exist. Diabetic pregnancy: Women with diabetes need to see an ophthalmologist early in pregnancy because retinopathy can develop rapidly during pregnancy. High-risk conditions: Combined kidney failure, amputation, or having diabetes for 20 years or more are high-risk factors for vision loss and should be examined by an ophthalmologist as soon as possible. Specialized eye examinations Usually the ophthalmologist will dilate the patient’s pupils and perform a series of imaging tests using special instruments. The most important of these are fluorescence angiography and coherent optical tomography, which are performed to further evaluate the condition of the retina and to guide laser treatment. fA involves the intravenous injection of fluorescein, the contrast agent enters the body and passes through the retinal vessels, showing vascular leakage, vascular occlusion and neovascularization, while OCT provides an examination of the macula and determines the presence of macular edema. These tests will help the doctor determine the cause of vision loss and decide if laser treatment is needed and the extent of laser treatment. If the doctor cannot see the fundus of the eye due to vitreous hemorrhage, an ultrasound exam should be done. Ultrasound can penetrate the blood buildup and see if there is a detachment in the retina. Treatment of diabetic retinopathy Internal treatment: The best treatment is prevention. Tight control of blood sugar can reduce the long-term vision loss of diabetic retinopathy. Hypertension and nephropathy can exacerbate macular edema and require aggressive treatment by an internist. For macular edema, the most effective and advanced treatment is to perform intraocular injection of anti-VEGF drugs, which can significantly reduce macular edema and inhibit neovascularization. Laser treatment: Laser treatment can shrink the abnormal neovascularization and reduce macular edema, which is commonly used for macular edema, proliferative diabetic retinopathy and neovascular glaucoma. Laser treatment is usually performed under surface anesthesia and requires the use of a contact lens placed on the surface of the eye in order to focus the laser on the retina. Lasers targeting macular edema are usually hit around the macula with the goal of reducing fluid leakage, reducing macular edema and preventing further vision loss. In PDR, the laser is applied to the entire retina except the macula, called total retinal photocoagulation (PRP). PRP causes atrophy of abnormal new blood vessels and prevents bleeding, preventing severe vision loss and retinal detachment due to vitreous blood accumulation. Vitrectomy: Vitrectomy requires an operating microscope and microsurgical instruments and is aimed at removing blood accumulation and scar tissue from the eye, removing abnormal hemorrhage-causing neovascularization, helping to reset the retina, and often requires supplemental laser during the procedure. Indications: Young, insulin-dependent diabetic patients with thick vitreous hemorrhages that require vitrectomy because of their high risk of retinal detachment and tendency to be masked by the hemorrhages. Patients with recurrent vitreous hemorrhage that cannot be absorbed or significantly affects vision, with a history of detrusor retinal detachment or macular distortion, should undergo prompt vitrectomy. To help reset the retina, air or silicone oil is usually injected intraoperatively. The air bubbles are absorbed within 1 to 8 weeks and require a prone position after surgery so that the air bubbles can help reset the retina. Patients should not fly during this time, which can cause an increase in intraocular pressure. The injected silicone oil will need to be removed surgically again. The risks of biosurgery include infection, bleeding, accelerated cataract progression, high intraocular pressure, etc. Finally, patients with diabetic retinopathy are reminded that: 1. Strict control of blood sugar will significantly reduce the risk of vision loss. 2. Regular eye examinations can help prevent vision loss. 3.Effective treatment is an important tool to prevent eye blindness. 4. All current treatments will not cure diabetic retinopathy, but will be effective in preventing further vision loss.