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Diabetic Retinopathy Treatment
Once diagnosed, diabetic retinopathy is treated in different ways. The treatment depends on the stage in which the ophthalmological issue is discovered, and how severe it is. Is directed to slowing or stopping the condition´s evolution.
In early diabetic retinopathy stages or, mild or moderate nonproliferative cases, treatment is not that urgent. However, your ophthalmologist will closely pay attention to the state of your eyes, and depending of it, he will recommend you treatment or not.
In this stage, prevention is key. Contact the physician that treats your diabetes mellitus (an endocrinologist is recommended) to see if there are measures to take to improve your disorder´s management. Usually, with good blood sugar levels (glycemia) the progression of diabetic retinopathy slows down.
In advanced diabetic retinopathy stages or, proliferative or installed macular edema cases, the best treatment at the moment is surgery. Depending on the problems that your retina may present, the options are different.
In early stages of proliferative retinopathy with macular edema, photocoagulation or focal laser treatment is practiced. This is a laser technique used to stop or slow the leakage process that some blood vessels may present generating the presence of blood and fluid in the eye. The leaks are treated with laser burns.
This procedure is commonly done in your ophthalmologist´s office or clinic in just one session. The blurred vision produced by the macular edema may not completely disappear with the procedure, but this can reduce the possibility of having a worst macular edema evolution.
Another type of photocoagulation is the pan-retinal one or scatter laser treatment. This procedure is used to shrink the abnormal blood vessels located in the portions of the retina far from the macula. Laser burns are specifically done, causing the shrinkage and scarring of these blood vessels (ischemia).
It is also done in your ophthalmologist´s office or clinic in multiple sittings. It may be possible to present some loss of peripheral, color or night vision after the treatment.
Before doing these procedures, the ophthalmologist has to dilate the pupil and apply a few anesthetic drops to achieve the eye´s numbness. The laser machine will be placed in front of the patient´s correspondent eye while the physician uses a special lens. During the procedure, the laser can be applied in a single spot or using a pattern. Is normal for the patient to see flashes of light while the laser is being applied. Blurry vision and headache are normal after the surgery.
In cases where there is a high amount of blood in the humor vitreous, the other surgical procedure known as vitrectomy is practiced. In this technique, a microscopic incision is done in your eye. With this incision, the doctor will remove the cloudy humor vitreous full of abnormal blood, replacing it with a saline solution. The scar tissue that is damaging your retina is also removed.
Local or general anesthesia may be used. This procedure is done in a hospital or specialized surgery center. The patient may be able to return home or maybe recommended to stay in the health center for one night. After the surgery, patients commonly use an Eyepatch for a small period of time to protect the eye, along with medicated eye drops to prevent infections.
Your ophthalmologist may suggest injecting medication into your eye, specifically into the humor vitreous. This medication is known as vascular endothelial growth factor (VEGF) inhibitors and it works by blocking the signals sent by the body that promote the generation and growth of new blood vessels. This treatment may be applied as a stand-alone therapy or combined with photocoagulation.
The use of corticosteroids, injected or implanted into the eye, is also recommended by ophthalmologists to treat macular edema cases. The implants used are biodegradable, may last months, and are able to release a continuous dose of corticosteroids. This treatment may increase the risk of cataract and glaucoma, for this reason, patients submitted to this should be regularly monitored for increased eye pressure. This therapy may be used alone or combined with other medical or surgical therapies.
