Diabetic retinopathy

Diagnosis

A thorough dilated eye exam is the most effective method for diagnosing diabetic retinopathy. For better observation inside your eyes during this examination, drops are used to enlarge (dilate) your pupils. Your close vision may get blurry while using the drops until they wear off many hours later.

Your eye doctor will examine both the inside and outside of your eyes during the examination.

Fluorescein angiography

An injection of dye will be given into your arm vein after your eyes have been dilated. Images are then captured when the dye passes through the blood vessels in your eyes. Blood vessels that are closed, damaged, or leaking might be located on the images.

Optical Coherence Tomography (OCT)

With this test, images show the retina in cross-section, revealing the thickness of the retina. This will aid in determining whether any fluid has spilled into the retinal tissue and the amount of fluid has leaked. OCT tests can then be performed to check on the effectiveness of the treatment.

Treatment

The aim of the treatment is to delay or stop the progression of diabetic retinopathy, which depends on the kind and severity of your condition.

Early diabetic retinopathy

You may not need therapy right away if you have mild or moderate nonproliferative diabetic retinopathy. To ascertain when you might require treatment, your eye specialist will nevertheless carefully check your eyes.

If there are any ways to improve your diabetes management, discuss them with your endocrinologist. The course of diabetic retinopathy can typically be slowed with effective blood sugar control in cases of mild to moderate disease.

Advanced diabetic retinopathy

You require quick medical attention if you have macular edema or proliferative diabetic retinopathy. Depending on the precise issues with your retina, you may have the following options:

• Injecting medications into the eye. The eye’s vitreous receives an injection of these drugs, which are also known as vascular endothelial growth factor inhibitors. They aid in terminating the development of new blood vessels and reducing fluid buildup.

Ranibizumab and aflibercept are two medications that the U.S. Food & Drug Administration (FDA) has approved for the treatment of diabetic macular edema. Bevacizumab, a third medication, is an off-label treatment option for diabetic macular edema.

Topical anesthesia are used while injecting these medications. There may be some moderate discomfort, such as burning, ripping, or soreness for up to 24 hours following the injection. Other negative effects may be infection and increased ocular pressure. There will be a need for more injections repeatedly. The drug is occasionally used with photocoagulation.

• Photocoagulation. The leakage of blood and fluid into the eye can be stopped or reduced by this laser procedure, sometimes referred to as a focused laser treatment. Laser burns are used during the operation to correct leakage from abnormal blood vessels.

A single session of focal laser therapy is often performed in your doctor’s office or eye clinic. The operation may not restore your vision to normal if you had macular edema-related blurry vision prior to the procedure, but it will lessen the likelihood of the worsening of the macular edema.

• Panretinal photocoagulation. The abnormal blood vessels may contract after receiving this laser therapy, also referred to as scatter laser therapy. During the operation, scattered laser burns are used to treat the retinal regions away from the macula. The abnormal new blood vessels shrink and scar as a result of the burns.

At most cases, it takes two or more sessions in your doctor’s office or eye clinic. After the surgery, your vision will be impaired for about a day and there may be some loss of night vision or peripheral vision.

• Vitrectomy. This technique makes a tiny incision in your eye to remove scar tissue that is pulling on the retina as well as blood from the vitreous (the interior of the eye). Using local or general anesthesia, it is carried out in a surgery center or hospital.

Treatment can not cure diabetic retinopathy, although it can delay or stop its progression. Future retinal degeneration and vision loss are still likely to develop due to diabetes’ lifetime nature.

You’ll need routine eye exams even once your diabetic retinopathy has been treated.