TREATMENT
With proper control of A1c, blood pressure, and blood cholesterol, we can mitigate the chances that diabetic retinopathy presents in the eye. Management of these risk factors should be as per the Primary Care Physician or Endocrinologist. However, sometimes, managing these risk factors may not be enough to thwart off the diabetic retinopathy.
We focus the treatment based on two notable exam findings, and each can have subcategories:
1) The amount of blood vessel growth and
2) The amount of swelling in the most crucial part of the back of the eye - the Macula.
Not all diabetic retinopathy needs to will be treated, and most will only need monitoring. All patients with diabetic retinopathy should focus on improving their A1c levels and all other risk factors.
Options for treatment include:
- • Injections in the eye (anti-VEGFs or steroids)
- • Lasers called Focal Laser or Pan-Retinal Photocoagulation (PRP)
- • Surgery The damage caused by diabetic retinopathy is not reversible.
The treatments above try to slow the progression of the disease. The goal of all three of these treatments is to decrease VEGF production, decrease inflammation and swelling, and make it harder for the growth of blood vessels to occur. Also, surgery removes the gel of the eye called the vitreous body. The vitreous body can act as a sponge for VEGF and a scaffold for new blood vessels to grow on. So in severe cases, the vitreous body is surgically removed.
The ophthalmologist will decide, based on the examination, which combination of these will be needed.
