Treatment

Lost vision from diabetic retinopathy cannot be restored, but early detection and treatment is often successful and can prevent vision from getting worse.

During the early stages of diabetic retinopathy, a person’s vision is monitored carefully, but treatment is usually not recommended until later because vision has not yet been affected early on.

Three treatment options for proliferative retinopathy are described below. Treatment options vary for each patient, so it’s important that you discuss your options with your eye doctor.

  • Scatter laser treatment:This treatment is done in your eye doctor’s office or an eye clinic and consists of a large number of microscopic thermal laser burns in the retina to shrink abnormal blood vessels.

    This treatment may slightly reduce peripheral vision, colour and night vision. Several treatments may be necessary as new blood vessels continue to grow, leaking blood into the eye.

  • Vitrectomy:If blood has leaked into the centre of the eye, the vitreous gel must be removed. A tiny incision is made in the eye, and the vitreous gel is replaced with a salt solution that mimics the normal fluids of the eye.

    After surgery, a person’s eye will be red and feel sensitive. If both eyes need the procedure, each surgery is done separately, several weeks apart. Surgery is done in a hospital either as a day procedure or overnight.

  • Intraocular (anti-VEGF) injections:Drugs that are injected into the eye to stop the growth of abnormal blood vessels are performed in your eye doctor’s office or an eye clinic. The drug Lucentis is a Health Canada approved treatment of macular edema associated with diabetic retinopathy. It works by reducing the growth of abnormal blood vessels and the leakage that occurs from these vessels. Speak with your eye doctor about the appropriate drug for you and if it is covered by your provinical health plan.

Macular edema is treated by:

  • Focal laser treatment. This treatment reduces the risk of further vision loss by 50 per cent and may improve vision for a small number of people. A large number of microscopic thermal laser burns are made around the macula, which slows down the leaking from the blood vessels.

    This procedure involves a topical anesthetic and is usually performed in your eye doctor’s office or an eye clinic. Permanent blind spots in peripheral vision may occur. Additional treatments may be necessary if abnormal blood vessels grow back.

  • Intraocular anti-inflammatory injections. This procedure, not used extensively anymore, involves an injection used to reduce swelling and inflammation inside the eye. This procedure takes about 15 minutes. In some severe cases several treatments may be required. Side effects may include the development of cataracts, glaucoma and, rarely, infection.

In the more advanced stages of diabetic retinopathy, other eye complications may need to be treated, such as a retinal detachment.

Ninety per cent of retinal detachment cases can be repaired if they’re caught in time. Vision loss may result from retinal detachment treatment, but this depends on how early the treatment occurs, as well as the condition of the macula - the central part of the retina responsible for seeing fine details, before surgery.

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