There are three types of diabetic retinopathy treatments.
Medical diabetic retinopathy treatments
If high levels of blood sugar, cholesterol or high blood pressure are contributing to your eye disease, Mr Patel will want to work with your diabetes doctor to help reduce risk factors which may be contributing to the diabetic retinopathy.
Laser diabetic retinopathy treatments
There are two main types of laser treatments for diabetic retinopathy:
Pan-retinal photocoagulation laser (PRP) treatment
We use pan-retinal photocoagulation laser treatment to treat proliferative diabetic retinopathy (PDR). PDR is an advanced form of diabetic retinopathy in which fragile, abnormal blood vessels grow on the surface of the retina which is at high risk of bleeding into the retina and the gel-like fluid of the eye (the vitreous). Though PDR itself does not necessarily cause symptoms, when bleeding occurs as a result of PDR, the vision is affected leading to vision loss. PRP laser treatment produces small hot spots on the retina leading to small laser burns. Usually, 2-3 sessions of treatment are needed to complete the treatment.
If successful, PRP laser treatment is associated with shrinkage of the abnormal blood vessels reducing the risk of vision loss through bleeding into the retina and the vitreous. Sometimes further PRP laser treatment is needed to help control the condition and further reduce the risk of vision loss. Occasionally the process of shrinkage of abnormal blood vessels after laser treatment can trigger a small amount of bleeding into the vitreous leading to a blurring of vision which usually settles over 2-3 months. However, the risk of vision loss from no treatment is much higher than with PRP laser treatment.
Macular laser treatment
The second type of laser treatment is called macular laser treatment and this is a milder form of laser treatment used to treat diabetic macular oedema (when the blood vessels in and around the centre of the retina start leaking or bleeding). The aim of macular laser treatment is to reduce the amount of fluid causing the central retina to swell or thicken to help stabilise the vision. Note that the past few years have seen eye injections overtake laser based treatments as the most effective treatment for diabetes related retinal blood vessel leakage however these still remains a role for laser treatment in certain circumstances.
Injection diabetic retinopathy treatments
Injection diabetic retinopathy treatments involve the injection of a highly specialised and targeted medicine into the gel-like fluid of the eye (the vitreous). The drug works by blocking the protein responsible for the growth of fragile blood vessels. This protein is called vascular endothelial growth factor (VEGF), and the medicines used are called anti-VEGF agents.
Different types of anti-VEGF agents are available, and Mr Patel can discuss the best treatment for you during the consultation. Studies have shown that repeated and regular anti-VEGF injections are effective in preventing blindness and can stabilise vision in patients with proliferative diabetic retinopathy.
Injection treatments don’t work if you are unable to have regular injections or if you fail to attend for regular follow-up consultations. The interval between anti-VEGF injections and the length of time you will need treatment for will depend on the severity of the condition and how you respond to the treatment.