What Is Diabetic Retinopathy? What Can I Do About It?
Treatment for diabetic retinopathy depends on the stage of the disease and whether diabetic macular edema (DME), a buildup of fluid in the macula, is present. Early diagnosis and timely treatment are the best ways to preserve vision.
Early Diabetic Retinopathy
In the early stages (mild to moderate non-proliferative diabetic retinopathy), treatment may not be needed immediately if vision is unaffected.
Management focuses on:
- Tight control of blood sugar (HbA1c)
- Blood pressure management
- Cholesterol control
- Regular dilated eye examinations to monitor for progression
Good control of diabetes can significantly slow the progression of diabetic retinopathy.
Anti-VEGF Injections
Anti-vascular endothelial growth factor (anti-VEGF) medications are the first-line treatment for diabetic macular edema and are also used for proliferative diabetic retinopathy. These medications reduce abnormal blood vessel growth and decrease leakage and swelling in the retina. Treatment typically begins with monthly injections, followed by longer intervals based on the patient’s response.
Corticosteroid Therapy
Steroid medications may be recommended for patients with diabetic macular edema who do not respond adequately to anti-VEGF therapy or who require fewer injections. Potential side effects include increased eye pressure (glaucoma) and cataract formation.
Laser Treatment
Laser therapy remains an important treatment option.
Focal/Grid Laser
- Used in selected cases of diabetic macular edema
- Seals leaking blood vessels to reduce retinal swelling
Panretinal Photocoagulation (PRP)
- Standard treatment for proliferative diabetic retinopathy
- Shrinks abnormal blood vessels and reduces the risk of severe vision loss
- May slightly reduce peripheral or night vision but greatly lowers the risk of blindness
Vitrectomy Surgery
Vitrectomy is recommended for advanced diabetic retinopathy when complications occur, including:
- Persistent vitreous hemorrhage (bleeding into the eye)
- Tractional retinal detachment
- Dense scar tissue pulling on the retina
During surgery, the vitreous gel and blood are removed, scar tissue is peeled away, and laser treatment may be performed.
Newer Advances
Recent advances have improved treatment durability and outcomes.
- Faricimab (Vabysmo®): Targets both VEGF and Angiopoietin-2, allowing many patients to extend treatment intervals up to 16 weeks.
- Aflibercept 8 mg (Eylea HD®): A higher-dose formulation that may allow treatment intervals of up to 16 weeks for some patients with diabetic macular edema.
- Researchers are actively studying sustained drug delivery systems, gene therapy, and novel medications to reduce treatment burden while maintaining vision.
With today’s treatments, most people with diabetic retinopathy can preserve useful vision if the disease is detected early and treated promptly. Anti-VEGF therapy, laser treatment, and modern vitreoretinal surgery have dramatically reduced the risk of severe vision loss from diabetes.