Retinopathy in diabetes involves damage to what structure?

• A. Blood vessels in the retina.
• B. The optic nerve.
• C. The lens.
• D. The cornea.

Answer: (A)

Retinopathy in diabetes involves damage to the blood vessels in the retina. Chronic high blood glucose injures the retinal microvasculature, leading to pericyte loss and endothelial dysfunction, which causes capillary leakage, microaneurysms, hemorrhages, and areas of ischemia. The resulting retinal ischemia drives the release of VEGF and can lead to new, fragile blood vessels growing on the retinal surface (proliferative diabetic retinopathy) and macular edema from leakage, both of which threaten vision. The optic nerve, lens, and cornea are not the primary sites affected by diabetic retinopathy, so the retinal blood vessels are the correct structure involved.