A 54-year-old man with a history of diabetes mellitus presents to the nurse practitioner with concerns about a new onset of eye symptoms. What is the pathophysiology of diabetic retinopathy?

Light-sensitive cells in the macula slowly break down, causing central vision to diminish over time

Hyperglycemia causes damage to blood vessels in the retina, leading to vision loss

Many degenerative processes denature and coagulate lens proteins in lens fibers, resulting in loss of transparency

Increased intraocular pressure is caused by anatomical changes in the lens or by inhibited or obstructed outflow