Eyes Information

There are various treatments available for the different manifestations of diabetic retinopathy. It used to be that laser treatment, of one form or the other, was the treatment of choice. Nowadays, there are intraocular injections of steroids, anti-VEGF medications, in addition to the traditional laser. Very soon, sustained release drug delivery systems will be an option, too.

Laser Treatment used to be the mainstay for treating macular edema, that is, swelling of the retina caused by leaky retinal blood vessels. The macular edema is the most common way diabetic patients can lose vision and it happens to almost every patient. If the swelling develops right in the center of the retina, called the macula, the vision may become blurred. The more severe the swelling, the more blurred the vision.

Retinal swelling can be treated with laser treatment. While this does not ensure that vision will improve, it is quite possible that the loss of vision is stopped. Intraocular injections of either steroids, and "anti-VEGF" medications, are becoming more popular amongst retina specialists for the treatment of diabetic macular edema (DME).
Both agents are delivered as an injection straight into the eye and have been shown to be highly effective in reversing the macular edema. While they may not yet have supplanted traditional laser therapy, both are becoming viable alternatives. Steroids are very effective in reversing macular edema. It seems as though inflammation plays a role in the "leaky" blood vessels common in diabetic macular edema.
Steroids are great at blocking inflammation.
"Anti-VEGF" medications are antibody-like molecules that are directed against Vascular Endothelial Growth Factor (VEGF). VEGF acts on normal blood vessels to make them leaky. (VEGF also causes abnormal blood vessels to grow along the surface of the retina and other internal structures of the eye, but see below).
By blocking VEGF from working by injecting "anti-VEGF" drugs, the leakage seems to stop, thereby improving the retinal swelling and vision. Popular "anti-VEGF" medications including Macugen, Lucentis and Avastin. Pan-Retinal Photocoagulation (PRP) is a method of using the laser to arrest the potential blinding effects of proliferative diabetic retinopathy.
This, for now, remains the best treatment for stabilizing the retina. In far advanced stages, a diabetic retinal detachment may form and vitrectomy eye surgery may be necessary to prevent blindness. Sustained Release Drug Delivery systems are presently being developed that will release drugs inside the eye for months at a time. One such system, called Ozurdex; (Allergan) is already FDA approved, but not for the treatment of diabetic retinopathy.