Retinal Diseases

Treatment of Diabetic Retinopathy

Diabetic retinopathy

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Nearly half of people with diabetes have some degree of diabetic retinopathy, a complication of diabetes that can result in blindness. After 20 years with diabetes, most patients have diabetic retinopathy. Treatment depends on the severity of the condition.

When people have diabetes, excess glucose in the bloodstream can cause the tiny capillaries in the back of the eye to swell and leak fluid. This causes blurry vision. Tiny new blood vessels grow out of the retina as the disease advances. These blood vessels may break and bleed into the vitreous, further impairing vision.

Annual eye exams and careful control of diabetes are the best ways to prevent complications and delay the need for treatment. At Mayo Clinic, ophthalmologists work closely with the diabetes care team to ensure that proper diabetes care is prescribed and implemented.

The symptoms of diabetic retinopathy are closely tied to diabetes. If the underlying diabetes is carefully controlled, the progression of the retinopathy can be greatly slowed.

There are two types of diabetic retinopathy; proliferative diabetic retinopathy is the more serious and should be treated promptly.

Nonproliferative diabetic retinopathy: This is the early stage of the disease. Symptoms often are mild or nonexistent. However, blurred vision may occur from swelling of the retina. This swelling occurs because the damaged blood vessels can ooze fluid.

Vision with advanced diabetic retinopathy

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You may not need treatment immediately. Your eye doctor will closely monitor changes in the retina. You need to work with your general medical doctors to control your glucose, blood pressure and cholesterol.

Proliferative diabetic retinopathy: This is the more advanced form of the disease, where abnormal new blood vessels grow on the surface of the retina or into the vitreous cavity. These new vessels may bleed into the vitreous, clouding or blocking vision. The blood vessels can pull on the retina, leading to retinal detachment.

For treatment, your ophthalmologist may recommend:

• Focal/grid laser photocoagulation, where lasers are used to create tiny burns on the retina to help seal off the abnormal blood vessels and stop leakage of blood and fluid into the eye.
• Panretinal photocoagulation, where a laser is used to burn spots over the entire retina while avoiding the macula.
• Vitrectomy, a procedure to clear the cavity of the eye of blood or tissue that can cloud vision.

For more details on these treatments, see treatment options.

Usually, treatment helps slow or stop the progression of diabetic retinopathy. Treatment doesn't cure the underlying disease. Careful diabetes management is important to reduce the risk of further eye damage.

New Drug Treatments

Mayo Clinic doctors are using anti-angiogenic and steroid drugs to inhibit the growth of abnormal blood vessels. Leakage from these blood vessels can lead to severe vision loss. Many times, these treatments are used in conjunction with laser therapy, to slow down blood vessel growth.