Treatment depends largely on the type of diabetic retinopathy you have. Your treatment will also be affected by how severe your retinopathy is, and how it has responded to previous treatments.
Early diabetic retinopathy
If you have nonproliferative diabetic retinopathy, you may not need treatment right away. However, your eye doctor will closely monitor your eyes to determine if you need treatment.
It may also be helpful to work with your diabetes doctor (endocrinologist) to find out if there are any additional steps you can take to improve your diabetes management. The good news is that when diabetic retinopathy is in the mild or moderate stage, good blood sugar control can usually slow the progression of diabetic retinopathy.
Advanced diabetic retinopathy
If you have proliferative diabetic retinopathy, you'll need prompt surgical treatment. Sometimes surgery is also recommended for severe nonproliferative diabetic retinopathy. Depending on the specific problems with your retina, options may include:
- Focal laser treatment. This laser treatment, also known as photocoagulation, can stop or slow the leakage of blood and fluid in the eye. It's done in your doctor's office or eye clinic. During the procedure, leaks from abnormal blood vessels are treated with laser burns. Focal laser treatment is usually done in a single session. Your vision will be blurry for about a day after the procedure. Sometimes you will be aware of small spots in your visual field that are related to the laser treatment. These usually disappear within weeks. If you had blurred vision from swelling of the central macula before surgery, however, you may not recover completely normal vision. But, in some cases, vision does improve.
- Scatter laser treatment. This laser treatment, also known as panretinal photocoagulation, can shrink the abnormal blood vessels. It's also done in your doctor's office or eye clinic. During the procedure, the areas of the retina away from the macula are treated with scattered laser burns. The burns cause the abnormal new blood vessels to shrink and scar. Scatter laser treatment is usually done in two or more sessions. Your vision will be blurry for about a day after the procedure. Some loss of peripheral vision or night vision after the procedure is possible.
- Vitrectomy. This procedure can be used to remove blood from the middle of the eye (vitreous) as well as any scar tissue that's tugging on the retina. It's done in a surgery center or hospital using local or general anesthesia. During the procedure, the doctor makes a tiny incision in your eye. Scar tissue and blood in the eye are removed with delicate instruments and replaced with a salt solution, which helps maintain your eye's normal shape. Sometimes a gas bubble must be placed in the cavity of the eye to help reattach the retina. If a gas bubble was placed in your eye, you may need to remain in a facedown position until the gas bubble dissipates — often several days. You'll need to wear an eye patch and use medicated eyedrops for a few days or weeks. Vitrectomy may be followed or accompanied by laser treatment.
Surgery often slows or stops the progression of diabetic retinopathy, but it's not a cure. Because diabetes is a lifelong condition, future retinal damage and vision loss are possible. Even after treatment for diabetic retinopathy, you'll need regular eye exams. At some point, additional treatment may be recommended.
Researchers are studying new treatments for diabetic retinopathy, including medications that may help prevent abnormal blood vessels from forming in the eye. Some of these medications are injected directly into the eye to treat existing swelling or abnormal blood vessels. These treatments appear promising, but they haven't been studied in long-term trials yet.
Mar. 27, 2012
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