Diabetic retinopathy is a frequent cause of blindness in the United States and the result of damage to the retina from systemic disease. The longer a person has diabetes, the higher his or her chances are of developing diabetic retinopathy. Severe cases of diabetic retinopathy can be reduced through proper treatment and monitoring of patients with diabetes.
A dilated eye exam is needed to look for signs of diabetic retinopathy, such as: (1) leaking blood vessels, (2) retinal swelling (macular edema), (3) yellow deposits on the retina (exudates), (4) retinal hemorrhages, (5) any changes in the blood vessels, and (6) damage to the nerve fiber layer (cotton wool spots). This is usually accompanied by a fluorescein angiography to detect any leaking vessels. An optical coherence tomography will allow detection of fluid in the retina causing macular edema.
There are three major treatment options for diabetic retinopathy: Laser photocoagulation, injection of Anti-VEGF or corticosteroid medication into the eye, and vitrectomy surgery.
Focal lasers can be used to treat macular edema. Panretinal photocoagulation or PRP is used to treat proliferative diabetic retinopathy (PDR), which untreated can result in bleeding inside the eye.
Injections of corticosteroids and Anti-VEGF medications are used to treat macular edema. Treatment usually requires multiple monthly injections of medication.
For some people, a vitrectomy surgery is required to restore vision. A vitrectomy is needed when there is blood inside the eye that does not resolve on its own or when there is traction on the retina causing a retinal detachment. The best way to manage diabetic retinopathy is by monitoring diet/blood sugars, blood pressures, and participating in regular exercise. Patients with diabetes should have regular dilated eye exams, the frequency depending on the severity of their diabetic retinopathy.