Vision loss from diabetic retinopathy can often be prevented– but only if detected and treated in a timely way by a retina specialist.
Diabetes and Eye Involvement
After many years, a majority of patients with diabetes will show changes in the back of the eye, called diabetic retinopathy. In most cases, careful observation by a retina specialist is all that is necessary.
Treatment of Nonproliferative Diabetic Retinopathy
When a patient with the less severe type of diabetic retinopathy, referred to as nonproliferative diabetic retinopathy, develops certain changes, a retina specialist may look into things more carefully with the use of various types of pictures; these include an optical copherence tomograph (OCT) and a fluoroscein angiogram (FA). These tests help detect the presence of any sight-threatening changes that may warrant treatment.
Most cases of sight-threatening changes from nonproliferative diabetic retinopathy result from swelling in the central vision–an area referred to as the macula. Depending on the location of the swelling, a retina specialist may choose to treat these areas with laser in the office.
If the swelling involves the central vision, then certain medications can be injected in the eye. There are various medications available, including Ozurdex, Macugen, Lucentis, Avastin and Eyelea. Your retina specialist should discuss with you these various alternatives.
Treatment of Proliferative Diabetic Retinopathy
In cases where a patient has had a long, and particularly challenging time with control of their diabetes, a more advanced stage of retinopathy may develop, referred to as proliferative diabetic retinopathy. In this case, new blood vessels grow on the surface of the retina (neovascularization); these blood vessels are very frail, and can easily bleed, causing a vitreous hemorrhage. If the blood vessels keep growing, they can then start to pull on the retina, creating a tractional retinal detachment.
If treated early by a retina specialist, proliferative diabetic retinopathy can be readily treated by laser and sometimes injections of medicine into the eye. If there is significant vitreous hemorrhage, then a retina specialist may advise a procedure referred to as a pars plana vitrectomy; this procedure uses tiny instruments in the eye to clear out the blood, while applying laser at the same time.
While diabetes may be a life-long condition, vision loss from diabetic retinopathy can be prevented. A retina specialist can help you navigate all the various treatment options that are available today.
Nader Moinfar, M.D., M.P.H.
Retina Specialist
Lakeland | Winter Haven
Zephyrhills | Lake Mary