Depending on the stage of diabetic retinopathy, the potential for and the amount of vision loss, it is possible to treat, stabilize and often reverse the effects of the disease. Treatment of diabetic retinopathy can entail the use retinal laser photocoagulation treatment as well as intravitreal injections of Vascular Endothelial Growth Factor (VEGF) Inhibitor drugs or other drugs. However, successful management of diabetic eye problems requires early diagnosis and treatment.
Nonproliferative Retinopathy Treatment
During the early stages of Mild Nonproliferative Retinopathy, Moderate Nonproliferative Retinopathy and the beginning of Severe Nonproliferative Retinopathy, it is not likely that you will need Laser Treatment, unless you have Diabetic Macular Edema.
However, in order to prevent the progression of Diabetic Retinopathy it is quite important to maintain good overall health. First, tight control of blood sugar levels is key to protecting the health of the small blood vessels. Patients should work to reduce any and all risk factors for vascular disease including controlling their blood pressure, not smoking, reducing dietary fat consumption to lower cholesterol and triglycerides and exercising regularly.
Proliferative Retinopathy, Laser Treatment & Retina Injections
Proliferative Retinopathy is treated with a Retinal Laser Photocoagulation procedure called “Scatter Laser Treatment”. The goal of Scatter Laser Treatment is to shrink abnormal blood vessels. We will place approximately 1,000 to 2,000 laser spots in areas of the retina away from the macula, causing the abnormal blood vessels to shrink. Since Scatter Laser Treatment requires a large number of laser spots, it is often necessary to use two or more sessions to complete the laser treatment. Sometimes patients who have had Scatter Laser Photocoagulation will experience some loss of their side or peripheral vision, some loss of night vision and a decrease in color vision. However, Scatter Laser Treatment is necessary to preserve the rest of your vision and stop the progression of the disease.
We may also discuss the use of anti-vascular endothelial growth factor (VEGF) treatment-such as Eylea® or Lucentis® or other types of retina injections as these retina injections may often be used in combination with laser treatment or even be the preferred treatment in your individual case.
When PRP and intravitreal injection are unsuccessful in stopping the progression of the proliferative retinopathy and when a vitreous hemorrhage occurs and does not clear on its own, or when a retinal detachment develops, then a Vitrectomy is often helpful. A vitrectomy involves inserting instruments into the eye, and removing the vitreous gel, any blood present in the vitreous cavity, and removing the scar tissue that has grown on the surface of the retina.
Diabetic Macular Edema, Laser Treatment & Retina Injections
Diabetic Macular Edema was traditionally treated with one of two types of Retinal Laser Photocoagulation procedures: “Focal Laser Treatment” or “Grid Laser Treatment”. Focal Laser treatment is used to close leaking microaneurysms in a limited area and Grid Laser treatment is used to treat a more diffuse swelling in the Macula. Laser treatment of Diabetic Macular Edema works to stabilize vision. In fact, laser treatment may reduce the risk of vision loss by 50 percent. In a small number of cases, if vision is lost, it may be improved. It is important to restate that this treatment is performed to keep vision from further declining, but does not usually result in improvement in vision already lost.
For most patients, anti-VEGF injections such as Eylea® and Lucentis® which are less destructive and safer than laser treatments, are considered as primary therapy for the management of vision-threatening complications of diabetic retinopathy such as diabetic macular edema (DME).
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