Diabetic Retinopathy occurs when high blood sugar damages the retina in the back of your eye and its blood vessels, leading to swelling and leakage, potentially blurring vision.

Untreated blood vessels can form scar tissue, leading to permanent blindness. Your doctor can provide medication or surgery treatments to decrease your risk of vision loss and preserve vision loss.

Focal laser treatment

Focal laser treatment reduces fluid leakage from retinal blood vessels, thus decreasing macular edema. This procedure may be done alone or combined with anti-VEGF injections for diabetic macular edema (DME). Focal laser photocoagulation is usually completed in the doctor’s office after topical anesthetic has been applied to your eye – typically taking only minutes!

Treatment for diabetic retinopathy should focus on preserving vision loss. To do so, the primary strategy involves controlling your blood sugar and attending regular dilated eye examinations (many health insurance plans cover them). Drops will be placed in your eyes to dilate pupil, before your opthalmologist uses optical coherence tomography (OCT) imaging technology to examine inside of eye. OCT provides detailed images of retina that allow doctor identify areas of swelling more accurately.

If you have proliferative diabetic retinopathy (PDR), laser surgery could be recommended to seal off leaking blood vessels and stop them from further leaking or growing. PDR can also cause vitreous gel in the back of your eye to separate from its light-receiving lining at the back, known as retinal detachment; laser surgery might also be used to remove scar tissue from your retina.

At its onset, non-proliferative diabetic retinopathy requires laser therapy as a preventative measure to avoid future vision loss. Your ophthalmologist might use focal laser treatment to create multiple small burns near leaking blood vessels in your retina; this reduces macular edema and thus further vision loss; it is a straightforward in-office procedure.

For advanced cases of PDR, your ophthalmologist may employ scatter laser treatment to create thousands of laser burns across retinal areas other than just the macula, in order to shrink abnormal blood vessels before they start bleeding again. A surgical procedure called vitrectomy may also be recommended to clear away blood and cloudy fluid from within retinal spaces and restore clearer vision.

Anti-VEGF injections

Anti-VEGF injections are the mainstay treatment for diabetic retinopathy. These drugs work by blocking production of an important protein found in our bodies which leads to abnormal blood vessel growth in the eye, often leading to macular edema (swelling of part of the retina).

Anti-VEGF treatments have dramatically altered the prognosis for people suffering from neovascular age-related macular degeneration (nAMD) and diabetic macular edema (DME). They have helped many avoid vision loss while stopping progression of disease.

These medications often require monthly or bi-monthly injections in order to be effective, which may create significant barriers to care that prevent visits and treatment responses from being optimal. Furthermore, pain from injections has been reported as hindering patient adherence.

Researchers are exploring strategies that could increase the efficacy of therapies by creating drugs that act independently from VEGF. One such approach, known as one-time gene therapy (ABBV-RGX-314), allows sustained release of drug into the eye for long-term release. Late breaking research presented at American Academy of Ophthalmology annual meeting offered promising insights.

Another promising innovation is a device being created by the U.S. Food and Drug Administration that allows a single intraocular injection to deliver anti-VEGF therapy over six months. If approved by FDA, this approach may reduce both monthly injections as well as their risks.

Susvimo Ocular Implant: Another therapy option available to people living with Neovascular AMD or DME may be the Susvimo implant, which releases ranibizumab directly into their retina over an extended time period. Approved by FDA, this new technology may enable those suffering from neovascular DR to eventually stop anti-VEGF injections without risk of vision loss.

Bevacizumab (Avastin), Aflibercept (Eylea), and Ranibizumab injected as eye gel are three popular treatments against anti-VEGF activity, each working differently to stop new blood vessel growth that causes macular edema or other retinal conditions. Recently, FDA has also expanded the use of injectable form of Aflibercept that allows easier administration with smaller needles than bevacizumab.

Scatter laser surgery

Laser surgery may be used to seal off leaky blood vessels and reduce retinal swelling. This allows light rays to focus properly again. When advanced proliferative diabetic retinopathy (PDR) and non-proliferative retinopathy is present, scatter laser panretinal photocoagulation might be used; during this procedure an eye surgeon places thousands of laser burns across areas other than the macula in order to shrink abnormal blood vessels that might be leaking blood and fluid into retinal spaces, helping shrink abnormal blood vessels that might otherwise leaking blood and fluid into retinal space.

PDR (diabetic retinopathy) is the most severe form of diabetic retinopathy and occurs when blood vessels in the retina begin leaking blood and fluid, leading to macular edema, which leads to blurry or dim vision. Although treatment cannot restore lost vision, it does help slow its progress while decreasing risk by over half. Macular edema causes blurry or dim vision that cannot be corrected otherwise.

Early stages of diabetic retinopathy often do not produce noticeable symptoms and routine monitoring may suffice in keeping your eyes healthy. However, once proliferative diabetic retinopathy advances to proliferative stages it is crucial that treatment begins immediately as weak blood vessels in your retina may begin leaking blood and fluid into your eye, leading to macular edema that could ultimately result in blindness.

At this stage, treatments include focal laser treatment and anti-VEGF injection therapy. The former uses laser beams to create burns in areas with leaky blood vessels while the latter involves injecting an eye gel containing anti-VEGF drugs which inhibit growth of new abnormal blood vessels. Both therapies may help prevent further vision loss while improving it in those suffering from macular edema.

Surgery may be required in some cases of proliferative retinopathy to treat severe vision loss. Laser burns placed near the macula help shrink unusual blood vessels and slow their growth, saving central vision while also protecting peripheral (peripheral), side, and color vision. For severe cases, vitrectomy surgery may be needed to drain off blood and fluid from within the eyeball.

Vitrectomy

Vitrectomy is an eye surgery procedure that involves extracting vitreous gel and replacing it with saline solution, typically under local or sometimes general anesthesia depending on your eye condition and overall health.

Procedure is an effective treatment for floaters, the tiny specks or cobwebs that appear across your field of vision. They’re caused by fluid collecting in the vitreous gel that fills up the eyeball; when this floater fluid blocks your retina it clouds your vision, which could impair vision altogether. When non-surgical options like laser therapy fail this procedure is often recommended as a more permanent solution.

If you suffer from proliferative diabetic retinopathy, new blood vessels that appear can leak fluid into the vitreous humour and lead to macular edema or retinal detachment. When this happens, vitrectomy surgery must be performed to drain off this fluid and repair your retinal structures.

Vitrectomy procedures can be done in-office using local anesthetic. They typically take between 30 minutes for simple cases and 2 hours for more complex ones; someone must accompany you home afterward as you will require medication to prevent infection and speed healing; your doctor will prescribe eye drops that reduce irritation during healing processes – although any contact between hands and eyes during that period should be avoided at all costs! For optimal results, no touching or scratching the eye for some time post procedure is advised.

At the time of vitrectomy, your surgeon will make several small incisions in your eye and insert a trocar, which allows repeated access to the vitreous cavity. Often three trocars will be utilized: one for infusion and illumination and two more to place surgical instruments like vitrectors or vitrectomy microscopes.

Technique and instrument advances have greatly expanded the spectrum of diseases treatable with 25-ga. vitrectomy.

Diabetic macular edema, particularly its panretinal form, can be effectively treated by using focal laser photocoagulation and vitrectomy. These procedures can save central vision while decreasing risk of progressive retinal detachment. Vitrectomy may also help stop proliferative diabetic retinopathy hemorrhages from proliferative diabetic retinopathy from progressing into retinal detachment progression. Therefore, screening patients with diabetes for vision-threatening macular edema as well as retinal and/or iris neovascularization before worsening of disease progression occurs.