Diabetic Retinopathy Treatment

Diabetic retinopathy is a complication of diabetes that weakens the blood vessels that supply nourishment to the retina (the light-sensitive lining in the back of the eye where vision is focused). When these weak vessels leak, swell or develop thin abnormal branches that bleed, vision loss occurs.

Currently, the most common and effective clinical treatment for clinically significant macular edema (CSME)-swelling of the central retina, called the macula, is anti-VEGF therapy – which is periodic intravitreal (into the eye) injection of a chemical called an “anti-VEGF”. Eylea (is one form of anti­ VEGF therapy, and recently approved by the Food and Drug Administration. Other variants of anti-VEGF injections include ranibizumab (Lucentis, made by Genentech/Novartis ), and bevacizumab (off label Avastin from Genentech). Each of these chemicals works in a similar way to inhibit blood vessel growth.

Focal laser coagulation may also be recommended for patients with clinically significant macular edema. The laser coagulates leaking blood vessels to dry up the fluid that is causing the swelling. Peri or intraocular steroids can also be used to reduce swelling. Optical Coherence Tomography (OCT) is a non-invasive test that uses light waves to measure the retinal thickness, and is used to analyze and guide the treatment of diabetic retinopathy.

A similar procedure called scatter laser photocoagulation (also known as pan-retinal photocoagulation or PRP) destroys abnormal blood vessel growth in patients with proliferative diabetic retinopathy (PDR). New studies show that frequent anti-VEGF injections may safely control PDR and thus avoid the laser treatment. If there is blood in the eye obscuring the laser, a vitrectomy may be performed to drain the blood in preparation for photocoagulation.

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