Treatment and Prevention of Diabetic Retinopathy
The only way to delay the ocular complications of diabetes is to exercise the tightest possible control of blood glucose. Therefore, the primary treatment for diabetic retinopathy is intensive control of the diabetes. In addition, blood pressure and serum lipid levels should be kept normal as far as possible.
There are two commonly used treatments for diabetic retinopathy are-
Laser photocoagulation - Severe macularedema and proliferative retinopathyare treated with laser surgery, calledlaser photocoagulation. Laser photocoagulation is a painless treatment in which a laser beam is aimed through the eye to destroy any new blood vessels and seal off those that are leaking. During the treatment, the patient may see bright flashes of light and the vision might remain blurred for a few hours after the procedure. It is quite possible to experience some discomfort in the eyes. People with proliferative retinopathy may lose some side (peripheral) vision after this surgery. Laser photocoagulation may also affect color and night vision. This procedure is not a cure for diabetic retinopathy. It just prevents further deterioration of vision, by preventing new blood vessels from leaking. Laser surgery reduces by 90% the chances that a person with diabetes will become legally blind.
Visual improvement is not guaranteed following the procedure.
Fluorescein angiography is used to plan laser treatment. Once the retinopathy advances to the proliferative phase, it is very difficult to reverse the damage caused.
Vitrectomy - People with proliferative retinopathy are always at risk for new bleeding. In cases with extensive bleeding in the vitreous, an operation called a vitrectomy may be required.
The hollow of the eyeball is filled with a gel-like substance called the vitreous humor, which helps give the eyeball its shape. Vitrectomy is often done under local anesthesia. With this procedure, the doctor makes a small incision in the white part of the eye (sclera). A small instrument is used to remove the cloudy vitreous and replace it with a vitreous substitute. The eye will be red and sensitive right after the procedure and the patient has to wear an eye patch for a short time to protect the eye. The doctor also prescribes medicated eye drops to prevent infection. Vision gradually improves after the vitrectomy, and the vitreous humor is gradually replaced. Even people with advanced retinopathy have a good chance of keeping their vision if it is treated before the retina is severely damaged.