Treatments for Diabetic Retinopathy
Treatments for Diabetic Retinopathy:
The main treatment for serious retina problems is laser eye surgery
(called "laser photocoagulation") where the blood vessels in the back of the eye are seared shut to prevent bleeding.
Another more radical form of treatment is called "vitrectomy", where the vitreous fluid of the eye is replaced with another substance. This is usually used in only more severe cases.
Treatments for Diabetic Retinopathy
The list of treatments mentioned in various sources
for Diabetic Retinopathy
includes the following list.
Always seek professional medical advice about any treatment
or change in treatment plans.
- Control blood sugars
- Quit smoking
- Control blood pressure
- Laser eye surgery
- Laser photocoagulation
- Scatter photocoagulation or panretinal photo-coagulation
- Focal photocoagulation - a focused attack on certain retinal areas.
- Retinal reattachment - A surgical procedure to reattach the retina wholly or partially, if it has become detached from the back of the eye.
- Vitrectomy
- Pan retinal photocoagulation
- Intravitreal Triamcinolone acetonide
Diabetic Retinopathy: Is the Diagnosis Correct?
The first step in getting correct treatment is
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Differential diagnosis list for Diabetic Retinopathy may include:
Hidden causes of Diabetic Retinopathy may be incorrectly diagnosed:
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Medical news summaries about treatments for Diabetic Retinopathy:
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Discussion of treatments for Diabetic Retinopathy:
Keep your eyes healthy: NIDDK (Excerpt)
First, keep your blood sugar and blood pressure as close to normal as
you can.
Your eye doctor may suggest laser treatment, which is when a light beam
is aimed into the retina of the damaged eye. The beam closes off leaking
blood vessels. It may stop blood and fluid from leaking into the vitreous.
Laser treatment may slow the loss of sight.
If a lot of blood has leaked into your vitreous and your sight is poor,
your eye doctor might suggest you have surgery called a vitrectomy
(vih-TREK-toh-mee). A vitrectomy removes blood and fluids from the
vitreous of your eye. Then clean fluid is put back into the eye. The
surgery often makes your eyesight better.
(Source: excerpt from Keep your eyes healthy: NIDDK)
Are You at Risk for Diabetic Eye Disease: NEI (Excerpt)
Your eye care professional may suggest laser surgery in
which a strong light beam is aimed onto the retina to shrink the
abnormal vessels. Laser surgery has been proved to reduce the risk
of severe vision loss from this type of diabetic retinopathy by 60
percent. (Source: excerpt from Are You at Risk for Diabetic Eye Disease: NEI)
Facts About Diabetic Retinopathy: NEI (Excerpt)
There are two
treatments for diabetic retinopathy. They are very effective in
reducing vision loss from this disease. In fact, even people with
advanced retinopathy have a 90 percent chance of keeping their
vision when they get treatment before the retina is severely
damaged.
These two treatments are laser surgery and
vitrectomy. It is important to note that although these
treatments are very successful, they do not cure diabetic
retinopathy. (Source: excerpt from Facts About Diabetic Retinopathy: NEI)
Facts About Diabetic Retinopathy: NEI (Excerpt)
Rather than focus the light on a single spot, your eye care
professional will make hundreds of small laser burns away from the
center of the retina. This is called scatter laser treatment.
The treatment shrinks the abnormal blood vessels. You will lose some
of your side vision after this surgery to save the rest of your
sight. Laser surgery may also slightly reduce your color and night
vision. (Source: excerpt from Facts About Diabetic Retinopathy: NEI)
Facts About Diabetic Retinopathy: NEI (Excerpt)
Instead of laser surgery, you may need an eye operation called a
vitrectomy to restore your sight. A vitrectomy is performed
if you have a lot of blood in the vitreous. It involves removing the
cloudy vitreous and replacing it with a salt solution. Because the
vitreous is mostly water, you will notice no change between the salt
solution and the normal vitreous.
Studies show that people who have a vitrectomy soon after a large
hemorrhage are more likely to protect their vision than someone who
waits to have the operation.
Early vitrectomy is especially effective in people with
insulin-dependent diabetes, who may be at greater risk of blindness
from a hemorrhage into the eye.
Vitrectomy is often done under local anesthesia. This means that
you will be awake during the operation. The doctor makes a tiny
incision in the sclera, or white of the eye. Next, a small
instrument is placed into the eye. It removes the vitreous and
inserts the salt solution into the eye.
You may be able to return home soon after the vitrectomy. Or, you
may be asked to stay in the hospital overnight. Your eye will be red
and sensitive. After the operation, you will need to wear an
eyepatch for a few days or weeks to protect the eye. You will also
need to use medicated eye drops to protect against
infection. (Source: excerpt from Facts About Diabetic Retinopathy: NEI)
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Book Excerpts: Treatment of Diabetic Retinopathy
Treatments of Diabetic Retinopathy: Online Medical Books
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for more information about the treatments of Diabetic Retinopathy.
Retinal Hemorrhage:
Treatment
(In A Page: Pediatric Signs and Symptoms)
-
Condition-dependent
–Treatment of underlying systemic disease is often the only treatment
-
Laser and surgical intervention may be of benefit in diabetic retinopathy, vein occlusions, hypertensive retinopathy, Eales disease, retinal vascular tumors
-
Prognosis depends on degree of retinal damage and neurologic involvement
-
Report suspect child abuse to state agency
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Retinal detachment:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Treatment depends on the location and severity of the detachment. It may include restriction of eye movements and complete bed rest until surgical reattachment is done. A hole in the peripheral retina can be treated with cryothermy; in the posterior portion, with laser therapy. Retinal detachment usually requires a scleral buckling procedure or a vitrectomy to reattach the retina. Basic salt solution is used to replace the retina while the vitreous is removed.
Certain types of uncomplicated retinal detachment may be treated by pneumatic retinopexy, in which an expansile gas is initially injected into the vitreous cavity and the patient’s head is positioned to facilitate retina reattachment. This procedure can be performed under local anesthesia.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Vascular retinopathies:
Treatment
(Professional Guide to Diseases (Eighth Edition))
No treatment has been shown to control central retinal artery occlusion. However, an attempt is made to release the occlusion into the peripheral circulation. To reduce intraocular pressure, therapy includes acetazolamide I.V., eyeball massage, thrombolysis by intra-arterial injection or I.V., high concentrations of inhaled oxygen, and anterior chamber paracentesis (to try to move the arterial obstruction into the peripheral field).
Therapy for central retinal vein occlusion may include aspirin, which acts as a mild anticoagulant. Patients with central retinal vein occlusion have reported improved vision after direct injection of tissue plasminogen activator into the retinal venous system. Laser photocoagulation can reduce the risk of neovascular glaucoma for some patients whose eyes have widespread capillary nonperfusion.
Treatment for nonproliferative diabetic retinopathy is prophylactic. Careful control of blood glucose levels may reduce the severity of the retinopathy or delay its onset. Patients with early symptoms of microaneurysms should have frequent eye examinations (three to four times per year); children with diabetes should have an annual eye examination.
Treatment for proliferative diabetic retinopathy or severe macular edema is laser photocoagulation, which cauterizes the leaking blood vessels. Laser treatment may be focal (aimed at new blood vessels) or panretinal (placing burns throughout the peripheral retina). Despite treatment, neovascularization continues to proliferate, and vitreous hemorrhage, with or without retinal detachment, may follow. If the blood isn’t absorbed in 6 weeks to 3 months, vitrectomy may restore partial vision.
Treatment for hypertensive retinopathy includes control of blood pressure with appropriate drugs, diet, and exercise. Treating the systemic hypertension should improve the condition of the eyes. If left untreated, hypertensive retinopathy results in severe vision loss.
The treatment goal of sickle cell retinopathy is to reduce the risk of, or prevent or eliminate, retinal neovascularization. Patients with symptoms should be followed twice a year with ocular examinations and dilated retinal evaluation. Proliferative disease should be treated with fluorescein angiography and panretinal photocoagulation. Cryotherapy hasn’t been proven to be effective and has a high complication rate.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Retinal detachment:
Treatment
(Handbook of Diseases)
Depending on the location and severity of the detachment, treatment may include restriction of eye movements and complete bed rest to prevent further detachment.
A hole in the peripheral retina can be treated with cryothermy; in the posterior portion, with laser therapy. Retinal detachment usually requires scleral buckling to reattach the retina and, possibly, replacement of the vitreous with oil, air, gas, or silicone.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Vascular retinopathies:
Treatment
(Handbook of Diseases)
The following measures are used to treat vascular retinopathy.
Central retinal artery occlusion
No treatment has been shown to control central retinal artery occlusion. However, an attempt is made to release the occlusion into the peripheral circulation.
To reduce intraocular pressure, treatments include immediate ocular massage, anterior chamber paracentesis after anesthetizing the surface with topical cocaine 2% to 4% drops, acetazolamide 500 mg I.V., and inhalation of carbogen (95% oxygen and 5% carbon dioxide) to improve retinal oxygenation. Because inhalation therapy may be given hourly for up to 48 hours, the patient should be hospitalized so vital signs can be monitored.
If the patient is young, the source of the occlusion may be the heart. Echo-cardiography may be necessary. Treatment in this case is to heparinize the patient.
Central retinal vein occlusion
Therapy for central retinal vein occlusion may include aspirin, which acts as a mild anticoagulant. Laser photocoagulation can reduce the risk of neovascular glaucoma for some patients whose eyes have widespread capillary nonperfusion.
Diabetic retinopathy
Treatment of nonproliferative diabetic retinopathy is prophylactic. Careful control of blood glucose levels during the first 5 years of the disease may reduce the severity of the retinopathy or delay its onset.
Patients with early symptoms of microaneurysms should have frequent eye examinations (3 to 4 times a year); children with diabetes should have an annual eye examination.
Treatment for proliferative diabetic retinopathy is laser photocoagulation, which cauterizes the leaking blood vessels, thereby eliminating the cause of the edema. Laser treatment may be focal (aimed at new blood vessels) or panretinal (placing burns throughout the peripheral retina).
Despite treatment, neovascularization doesn’t always regress, and vitreous hemorrhage, with or without retinal detachment, may follow. Vitrectomy is the treatment of choice for vitreous hemorrhage to restore vision.
Hypertensive retinopathy
Treatment for hypertensive retinopathy includes control of blood pressure with appropriate drugs, diet, and exercise.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
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