Dec 10, 2021
Options for Advanced Diabetic Retinopathy
For those with advanced retinopathy in their eyes, as determined by your eye doctor, there are several treatment options based on the specific complications with your eye. Some treatments might include:
Injections into the eye:
There are certain injections that help to slow the development of new blood vessels in the eye that can be a part of retinopathy. They also will reduce the fluid in the eye that builds up over time with retinopathy. These injections, called vascular endothelial growth factor inhibitors, will be injected into the eye as an outpatient, in-office procedure. If receiving these injections, expect blurry vision for the following several hours and arrange a ride home.
For these injections, you will have topical anesthesia in the eye. Often patients report some mild discomfort with the injections, most of the time including symptoms such as redness, burning sensations, tearing, or slight pain. Some patients have a buildup of pressure in the eye. If these symptoms persist or worsen after 24 hours you should contact your ECOTN location.
These treatments will be a series of injections and will need to be repeated at intervals. These injections are most frequently a treatment to prepare the eye for photocoagulation.
Photocoagulation is the use of lasers to stop or retard the flow of blood and leakage into the eye from weak vessels. Sometimes you will hear this referred to as focal laser treatment.
This procedure is usually done as an outpatient treatment in your doctor’s clinic or office. Most often, this is a single-time treatment. This treatment is done to help stop macular edema from progressing and becoming worse.
This is similar to regular photocoagulation, but this treatment is known as scatter laser treatment and is done to shrink the abnormal blood vessels that have grown in the eye. During this procedure, the scattered lasers burn the areas of the retina away from the macula, and the new vessels shrink and scar.
This procedure is also usually done in your doctor’s clinic, but usually is a series of two or more sessions. Plan ahead for your vision to be blurred for a day or so following the treatment. Some people experience a loss of peripheral or night vision after receiving this treatment.
In this procedure, your doctor will make a small incision in your eye and remove blood from the middle of the vitreous area of the eye. He or she may also choose at that time to remove any scar tissue that is tugging at the retina. This procedure is done as an outpatient procedure but done in a surgical center or hospital, and is done most often using local or general anesthesia.
It is important, especially if you are a diabetic or have a history of prolonged high or uncontrolled blood sugars, to make regular eye exams with your eye care professional, with dilation to check the back of your eyes. If your eye care professional sees any evidence or suggestion of abnormal vessel growth or fluid in your eye, they may refer you to a retina specialist who will be able to evaluate the severity of your condition and prescribe treatments to slow down the growth of abnormal blood vessels and help remove the fluid in your eye.
While macular edema, or retinopathy, cannot be reversed, these treatments, as well as continued management of blood sugars, will help slow the progression and severity of complications.