Anemia and PDR

I have been type 1 for 29 yrs. Was diagnosed with minimal background retinopathy 25 yrs ago. Have had yearly check-ups. In 2011, I was diagnosed with PDR, had laser, then a year ago my retina detached and I had a vitrectomy. Now I have a cataract in that eyeand am hoping to wait until 2013 for surgery.

I have been anemic to borderline anemic for several years. I was told that my being anemic may have contributed to the PDR, because there is less oxygen being carried by your RBC's and when your eyes aren't getting the oxygen they need, you develop those pesky fragile blood vessels known as PDR. (At least that is the "jist of what i got from the conversation").

Anyone else been told that if you are anemic you need to treat it because of PDR? Only 1 physician has ever said anything about it. My other "specialists" just blow it off and tell me that my blood level is not that low.

Dear jwinc,

1. Proliferative diabetic retinopathy is a result of retinal ischemia.

2. As you stated correctly, any ischemic tissue is not receiving sufficient oxygen due to lack of blood supply.

3. Diabetes causes ischemia due to insufficient "plumbing." Diabetes can cause loss of normal blood vessels and therefore decreased blood supply. Examples include neuropathy (loss of normal blood vessels that supply the little nerve endings at the tip of fingers and toes).

4. Anemia is a decrease in the actual concentration of oxygen normally carried in blood.

5. As you now know, having anemia compounds any tendency towards developing PDR as it worsens the lack of oxygenation.

Hope this was helpful. Thanks, too, for you input on the website!


thanks dr. randall wong ( randy ) for answering jwinc's question.


You are welcome. I hope it made some sense. Was up late in anticipation of this storm hitting the East coast and was a bit groggy.


Thanks for your reply Dr Randy Wong. I wonder why my Drs (internist, endo, regular ophthalmologist, and the 1st retinal ophth. surgeon) had never mentioned the anemia/PDR relationship before. It wasn't until I happened to see "Dr Wonderful" (an associate of the 1st retinal surgeon), that this was even mentioned. And by "Dr Wonderful", I mean this guy is AWESOME (no sarcasm meant at all).

Makes me a bit angry and sad as I have always had a yearly eye exam (stable very minimal non-prolif retinopathy-----with only a few very, very tiny spots until 2 yrs ago), then it was full-blown PDR. I exercise, try to keep my bs under control as best I can (test my bs at least 8-12 times a day, sometimes more), and still eye up with severe eye disease.

Anyone know if repeated Hypoglycemia events has any effect on PDR? BS frequently in the 30's, 40's, and 50's .

Stay safe.

Yes, Hypogycemia causes hypoxia and reduced blood flow. I was told to avoid lows even more than highs. If you address the Anemia and keep your sugars from going below 70, you should see a improvement in the eyes. I understand it all to well with my NPDR that gets much worse with lows. I think of it as this, the less food ( glucose) the body has, the more it slows down... the eyes are affected easily by this,and the fact we can't regulate the blood flow ( like the handle on the garden hose is busted on on "high" all the time) fluctuations like that matter. Good luck!

i have hypo-unawareness so when my bg is too low the only symptom i have is when i close my eyes i see large white spotin my right eye

so i take glucose & then retest & am still low, then eat food

that's why i need to test 12/14 times a day

to prevent lows

the other day my bed time bg was 49 & i had no symptoms. took glucose + yogurt 20 carb then at 2 am bg was 142 then at 4 am bg was 116 then at 7:30 am was 87...strange for me

I might suggest a Dexcom CGM if you can get it covered. It took going through hoops to get mine covered but it is a godsend. I used to take 20-30 tests a day but this when calibrated aloows me more peace of mind and can tell you when you are going low. Now I only do 8-10 sugars a day to compare. Good luck.

jwinc: Reduced glucose levels for more than 45 minutes can cause ischemic retinal damage. I got two CWS as a result of low blood sugar at night. I need to avoid lows and keep my nigh time levels more elevated to avoid hypoxia. I also sleep with a night light to cut down on oxygen needs.

Jwinc, I recently discovered this group and glad I did. You mentioned ischemia, which is is the narrowing of the blood vessels in the eye. I wanted to know if it has affected your vision? I too have been anemic off and on for the 54 years of living with Diabetes and in the last say under 10 years have had a vision problem. I had laser over 30 some years ago and haven't had any problems until the last few years. Eye specialist can't seem to find out what the problem is. I was wondering if you do have problems seeing, is it something you can see but drs can't see from the outside. I know I seem to be babbling but at the moment can't seem to explain it any other way then that. When I read or look at things there always seem to be some type of obstructions in my left eye.

Betty~ I can relate. My vision issue is really hard to describe. Does your vision get "wierd" when your blood sugar is low? The vision in my affected eye is distorted. It reminds me of when you rub your eye and then try to focus. Looking at an eye chart, the 2nd letter in the row is lower than the others and the 3rd letter is higher than the others. Also everything is smaller.

When my retina detached, I also had a membrane peel done. Since then, when I look at a line, there is a break in it. One part of the line is lower than the other part. Kinda like a "Z" but the lower line is much closer to the top line.

I don't think anemia itself causes vision problems. Have you had an OCT scan done? It is a 2-dimentional scan that gives cross-sectional image of the eye and shows problems below the surface of the retina. Do you have an ERM (epiretianl membrane)?

I always try and get a copy of the Drs office notes. It is amazing the information you find out that 1. either the Dr failed to mention or 2. you forgot exactly what the Dr said.

Josh~ What is CWS?

My CDE recently mentioned that there is a high correlation btwn hypoglycemia and increased strokes. Something about plaque breaking off (can't remember why. possibly spasms within the vessels) causing a stroke.

What is the correlation brwn a night light and oxygen needs?

Jwinc, I know what you mean. At one time I use to get a blue tinge to my vision. But the problem I have now is there always seems to be something impairing the vision in my left eye. It looks like there is always something there that only I can see. I had Cataract surgery in 2005-2006 and vision was good until a few years ago. The other procedures you've had I haven't had. I know what you mean about getting copies with my Medical doctors they always give me copies but with eye doctor I don't have any...besides I'm tired of all that paperwork I just want to have clear vision. I hope you get results to your problem.