Treatment options for Diabetic Retinopathy

In any case of diabetic retinopathy, ophthalmologists are not able to cure its etiologic cause as an antibiotic kills bacteria. In most patients, medications and/or laser surgery can slow or halt the condition’s advance.

Patients who keep blood sugar and blood pressure at healthy levels decrease their risk of developing diabetic retinopathy. In patients who already have diabetic retinopathy, lower blood-sugar and blood-pressure levels can reduce the condition’s likelihood to worsen. After diabetic retinopathy develops and threatens a patient’s vision, laser treatment is the only method proven effective for diminishing vision loss – though a more recent injection therapy has promise.

The most common treatment is laser light, which the physician directs into the eye to try to seal the leaky micro-aneurysms that are swelling the retina. These micro-aneurysms are typically 0.5mm to 3mm from the center of the macula, a very critical component of the retina that enables people to read and drive. Laser treatment kills some of the eye's healthy nerve cells, creating blind spots, but fortunately the spots, or scotomas, are so miniscule that patients commonly don’t notice them.

Laser treatment is done on an outpatient basis, taking about 20-30 minutes per eye. The patient's eyes are numbed with topical anesthetics drops, and uncommonly an anesthetic shot, before treatment.

A more recent therapy involves the injection of corticosteroids and other medication directly into the eyeball. These injections work in two ways: stabilizing the abnormal blood vessels so they don't leak as much, and working against the body's production of a protein that creates leaky vessels. Early data from many thousands of patients suggests that these injections are effective against diabetic retinopathy's contributing factors; in studies, some patients’ retinas have returned to normal thickness after having been edematous.

Further studies are ongoing, but the injections are available at UW Medical Center. It is worth noting that these injections are not curative, but must be repeated every four to six weeks initially, and physicians aim to gradually increase time between treatments thereafter.

This treatment is done on an outpatient basis, taking about 15-20 minutes per eye. The patient's eyes are treated with topical anesthetic drops before treatment.