Diabetic Retinopathy Treatment
Diabetic retinopathy is an eye condition that can occur as a complication of diabetes. The blood vessels in the retina become damaged due to high blood sugar levels. The high blood sugar causes the eye’s blood vessels to swell and leak, or it can cause blood vessels to close, stopping adequate blood flow to the eyes. Abnormal blood vessels can also grow as a result. These change in the blood vessels of the retina can at first cause blurry vision, followed by diminished vision or blindness.
There are two types of diabetic retinopathy:
Early Diabetic Retinopathy
This type of diabetic retinopathy is the most common. It is also called nonproliferative diabetic retinopathy new blood vessels have not grown (or proliferated) in the retina. The walls of the blood vessels in the retina become weak, with tiny bulges that protrude from the walls and leak fluid and blood into the retina. Larger vessels in the retina can become enlarged or irregular in size.
Edema, or fluid buildup, can also occur in the macula (center of the retina) as a result of the damage to the blood vessels. This can decrease vision and must be treated to avoid permanent vision loss.
Advanced Diabetic Retinopathy
Advanced diabetic retinopathy is also called proliferated diabetic retinopathy. Here, blood vessels become closed off and new abnormal vessels grow in the retina. These abnormal blood vessels are weak and can leak into the vitreous – the clear, jelly-like substance at the center of the eye.
As the condition progresses, scar tissue from growth of the new blood vessels can cause the retina to detach from the back of the eye. If the blood vessels interfere with the normal flow of fluid in the eye, it can damage the optic nerve, resulting in glaucoma.
Treatment of Diabetic Retinopathy
The best way to prevent vision loss is regular visits to your ophthalmologist. Your Union Square Eye Care specialist will treat you based on the type of diabetic retinopathy you have, as well as its severity.
Treatment for Early Diabetic Retinopathy
If you have early (or nonproliferative) diabetic retinopathy, you might not require treatment immediately, however your ophthalmologist will closely monitor your eyes to watch for progression of the condition.
Your ophthalmologist will also recommend that you work with your endocrinologist to best manage your diabetes, as this can affect the severity of your diabetic retinopathy. At this stage, good blood sugar control can help slow the progression of diabetic retinopathy.
Treatment for Advanced Diabetic Retinopathy
If you have advanced (or proliferative) diabetic retinopathy, you’ll need prompt treatment from your ophthalmologist. Depending on the specific problems with your retina, your doctor will work with you to determine the best course of treatments, which can include:
Various laser treatments can be used to address advanced diabetic retinopathy.
Photocoagulation, also known as focal laser treatment, can stop or slow the leakage of blood and fluid in the eye. It is commonly used to treat advanced diabetic retinopathy. During this procedure, light energy is applied to the retina to stop the growth and development of new blood vessels. The procedure may not reverse loss of vision, but it can help preserve your existing vision and prevent further vision loss. Focal laser treatment is usually done in a single session in the doctor’s office.
Also known as scatter laser treatment, panretinal photocoagulation is used to shrink the abnormal blood vessels. The areas of the retina around the macula are treated with scattered laser burns. The burns cause the abnormal new blood vessels causing decreased vision to shrink and scar.
Panretinal photocoagulation is usually done in your doctor’s office in two or more sessions. Patients often have blurred vision for about 24 hours and can experience some loss of peripheral vision or night vision after the procedure.
Your ophthalmologist may recommend medications that are given by injection into the eye. These medications are called vascular endothelial growth factor inhibitors (anti-VEGF). They are injected into the vitreous of the eye to help stop growth of new blood vessels and decrease fluid buildup.
Two drugs used for the treatment of advanced diabetic retinopathy are ranibizumab (Lucentis) and aflibercept (Eylea). These drugs are injected using topical anesthesia. The injections can cause mild discomfort, such as burning, tearing or pain, that should last no longer than 24 hours. The injections will need to be repeated, often once a month to being with. In some cases, the medication is used with photocoagulation.
A surgery called a vitrectomy may be recommended by your ophthalmologist. In this procedure, a tiny incision is made in your eye to remove blood from the vitreous in the middle of the eye, as well as any scar tissue that could be pulling on the retina. This surgery is done at a hospital or surgery center under local or general anesthesia.
Treatment can slow or stop the progression of diabetic retinopathy, but there is no cure because diabetes is a lifelong disease. Even after treatment for diabetic retinopathy, you’ll need regular eye exams. At Union Square Eye Care, we are here to provide long-term care to treat your diabetic retinopathy and ensure the best possible quality of life.