Diabetic Retinopathy: Pan Focal Laser
Diabetic Retinopathy: Focal Laser
Intravitreal Injections: Overview
New Treatments are here now – Vascular endothelial growth factor (VEGF) is elevated when the retina becomes ischemic and neovascularization occurs. A new therapy is available that lowers or blocks the effects of VEGF. This treatment is the injection of anti-VEGF medications into the eye so that abnormal blood vessels shrink and stop leaking.
Traditional Treatments for Diabetic Retinopathy
The major retinal complications of diabetes can be classified into non-proliferative retinopathy, proliferative diabetic retinopathy and macular edema.
Non-proliferative diabetic retinopathy can range form very mild which has small balloon-like defects in the retinal vessels (microaneurysms) to severe which has blockage of the retinal vessels which causes poor nutrition to the retina (ischemia).
Treatment: Non-proliferative diabetic retinopathy usually does not require treatment but the patient?s blood sugars, blood pressure and cholesterol levels should be controlled so that these complications do not progress to a more severe form of retinopathy.
Proliferative diabetic retinopathy occurs when the lack of blood flow becomes so severe that abnormal new blood vessels are stimulated to grow on the surface of the retina. These new blood vessels, called neovascularization, are fragile and can leak blood into the posterior chamber of the eye cause what is known as a vitreous hemorrhage. As long as it is present, the blood can block the patient’s vision. Proliferative diabetic retinopathy is diagnosed by examination and fluorescein angiography.
Treatment: The treatment for proliferative diabetic retinopathy is laser surgery to shrink the abnormal blood vessels and preserve vision in the central area of the macular which allows us to read and see fine detail. Treatment for a vitreous hemorrhage is a surgical procedure called a vitrectomy that removes the blood that blocks the vision.
Macular edema occurs when the blood vessels leak fluid and the retinal tissue swells causing blurry vision. Clinically significant macular edema (CSME) can be associated with non-proliferative or proliferative retinopathy and is diagnosed by examination and optical coherence tomography (OCT).
Treatment: The treatment for CSME is focal laser surgery which treats the area surrounding the leaking vessels. It may be necessary to have more than one treatment with the laser for either the CSME or the PDR.