Question

Diabetic Retinopathy (Eye Damage)

How is diabetic retinopathy treated?

A Answers (4)

  • If nonproliferative retinopathy has led to macular edema (swelling of the retina), laser photocoagulation, a type of surgery that uses an intense beam of light,  is used to burn and seal the leaking blood vessels and decrease tissue swelling, thereby decreasing the likelihood of further vision deterioration.

    For proliferative retinopathy, laser surgery known as panretinal photocoagulation, which uses a scattered laser, is used to stop the growth of new blood vessels, thereby decreasing the likelihood of serious side effects including vitreous hemorrhage and retinal detachment.

    Vitrectomy is a surgical treatment that can help restore vision by removing a vitreous hemorrhage or repairing retinal detachment.

    Several new treatments are also being evaluated to determine if they curb progression of retinopathy or decrease vision loss associated with it. These treatments include oral medications for nonproliferative disease and intraocular injections of anti-inflammatory medications (steroids) for macular edema.

  • AManvi P. Maker, Ophthalmology, answered on behalf of NorthShore University HealthSystem
    Manvi Maker, MD - How is diabetic retinopathy treated?

    Diabetic retinopathy is treated based on the extent of the retinopathy in the back of the eye. Watch this video to learn more from Dr. Manvi Maker about how diabetic retinopathy is treated.

  • During the first three stages of diabetic retinopathy, no treatment is needed unless you have macular edema. To prevent progression of diabetic retinopathy, people with diabetes should control their levels of blood sugar, blood pressure, and blood cholesterol.

    Proliferative retinopathy is treated with laser surgery. This procedure is called scatter laser treatment. Scatter laser treatment helps to shrink the abnormal blood vessels. Your doctor places 1,000 to 2,000 laser burns in the areas of the retina away from the macula, causing the abnormal blood vessels to shrink. Because a high number of laser burns are necessary, two or more sessions are usually required to complete treatment. Although you may notice some loss of your side vision, scatter laser treatment can save the rest of your sight. Scatter laser treatment may slightly reduce your color vision and night vision. Scatter laser treatment works better before the fragile new blood vessels have started to bleed. That is why it is important to have regular, comprehensive dilated eye exams. Even if bleeding has started, scatter laser treatment may be possible, depending on the amount of bleeding. If the bleeding is severe, you may need a surgical procedure called a vitrectomy. During a vitrectomy, blood is removed from the center of your eye.

    This answer is based on source information from the National Institute of Diabetes and Digestive and Kidney Diseases.

  • The best treatment is to prevent the development of retinopathy as much as possible. Strict control of your blood sugar will significantly reduce the long-term risk of vision loss from diabetic retinopathy. If high blood pressure and kidney problems are present, they need to be treated.

    Medical treatment. Injections of anti-VEGF medication in the eye can stop the growth of new blood vessels and subsequent bleeding. VEGF is necessary for the eye to build new blood vessels and the use of anti-VEGF medication causes regression of these fragile and abnormal blood vessels. Sometimes a steroid medication may also be used.

    Laser surgery. Laser surgery is often recommended for people with macular edema, PDR and neovascular glaucoma.

    For macular edema, the laser is focused on the damaged retina near the macula to decrease the fluid leakage. The main goal of treatment is to prevent further loss of vision. It is uncommon for people who have blurred vision from macular edema to recover normal vision, although some may experience partial improvement. A few people may see the laser spots near the center of their vision following treatment. The spots usually fade with time but may not disappear.

    For PDR, the laser is focused on all parts of the retina except the macula. This panretinal photocoagulation treatment causes abnormal new vessels to shrink and often prevents them from growing in the future. It also decreases the chance that vitreous bleeding or retinal distortion will occur.

    Multiple laser treatments over time are sometimes necessary. Laser surgery does not cure diabetic retinopathy and does not always prevent further loss of vision.

    Vitrectomy. In advanced PDR, your ophthalmologist may recommend a vitrectomy. During this microsurgical procedure, which is performed in the operating room, the blood-filled vitreous is removed and replaced with a clear solution. Your ophthalmologist may wait for several months to see if the blood clears on its own before performing a vitrectomy.

    Vitrectomy often prevents further bleeding by removing the abnormal vessels that caused the bleeding. If the retina is detached, it can be repaired during the vitrectomy surgery. Surgery should usually be done early because macular distortion or traction retinal detachment will cause permanent visual loss. The longer the macula is distorted or out of place, the more serious the vision loss will be.


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