Diabetic retinopathy treatment aims to prevent the problem from developing. There are three primary therapeutic options: These therapies will be administered based on the stage of the disease and the condition of the eye.
- Laser treatment (retinal photocoagulation)
- Anti-VEGF therapy (intravitreal injection)
- Vitreous surgery
Laser therapy (retinal photocoagulation) is a treatment that prevents the development of new blood vessels by irradiating the retina with a laser. When the blood flow of the retinal blood vessels is poor and the retina falls into an ischemic state, new blood vessels grow. Since new blood vessels are not normal blood vessels, they are prone to bleeding and have various adverse effects on the retina.
Therefore, by performing laser treatment, we can prevent the development of new blood vessels and prevent blood flow from worsening or stopping.
Laser irradiation takes about 15 minutes, and in some cases can be done on an outpatient basis. However, depending on the condition of the retina, it may not be possible to complete the treatment in one session, and multiple sessions may be required.
Anti-VEGF therapy is a treatment that suppresses the development and proliferation of new blood vessels by injecting anti-VEGF drugs into the eyeball. Macular edema, in which the part of the retina that is related to vision, the macula, swells, can cause serious vision loss.
Macular edema is caused by new blood vessels, and the cause is said to be a protein called VEGE (vascular endothelial growth factor). Injections will be administered periodically while monitoring the condition through medical examinations and tests.
Vitreous surgery is a surgical procedure that aims to restore visual function when diabetic retinopathy progresses and vitreous hemorrhage or retinal detachment occurs by removing the hemorrhage or restoring the detached retina. Vitreous surgery is one of the surgeries in ophthalmology that requires advanced technology.
In Early Stages
In the early stages, called "simple diabetic retinopathy," abnormalities begin to appear little by little in the blood vessels of the retina. Symptoms include small dot-like bleeding and microaneurysms, in which the capillaries swell like lumps.
These abnormalities may improve with improved blood sugar control, so diabetes treatment takes priority. Sometimes, oral administration of retinal circulation-improving drugs that dilate blood vessels may be performed.
In the medium term
The middle stage is called "preproliferative diabetic retinopathy."
This is the stage where ischemic areas can be seen, where blood flow to the retinal blood vessels is poor. As the ischemic areas spread, the brain begins to prepare to create new blood vessels to supply the missing oxygen and nutrients.
In addition to blood sugar control, treatment includes laser treatment of the retinal ischemic areas and, if macular edema is present, anti-VEGF therapy.
In terminal cases
The final stage is called "proliferative diabetic retinopathy," in which new blood vessels grow into the ischemic areas of the blood vessels.
Abnormal new blood vessels are prone to bleeding, which can have a significant impact on vision (vitreous hemorrhage). In some cases, new blood vessels can cause retinal detachment due to irritation.
Treatment includes laser therapy to prevent the growth of new blood vessels in a wide area other than the macula, or vitrectomy if vitreous hemorrhage or retinal detachment has occurred.
How To Prevent Diabetic Retinopathy
Once diabetic retinopathy has progressed, it cannot be cured completely even with treatment, so it is most important to prevent it from developing.
Here we have summarized what you need to do to prevent diabetic retinopathy, so please take a look.
Blood Sugar Control
Blood sugar control means maintaining appropriate blood sugar levels. Blood sugar levels are brought closer to normal levels through diet, exercise, and sometimes drug therapy.
Blood sugar control is an effective way to prevent diabetic retinopathy. In the early stages, good blood sugar control can slow the progression of retinopathy and even halt it with minimal impact.
However, caution is required in rapid blood sugar control. The reason is that it has been found that suddenly lowering blood sugar can worsen retinopathy. Therefore, the improvement rate of HbA1c (hemoglobin A1c), which is the evaluation standard for diabetes, should not exceed 0.5 to 1% per month.
Regular Examination
Diabetic retinopathy generally has no symptoms. It may progress without you being aware of it, and if you notice it when it causes macular edema or vitreous hemorrhage, it may have progressed to the middle to final stages.
If you are diagnosed with diabetes, you should first have an eye examination even if you have no eye symptoms. Regular visits to an ophthalmologist as well as an internal medicine doctor will help prevent diabetic retinopathy.
Summary
Diabetic retinopathy is a scary disease that progresses without any noticeable symptoms. However, if it is detected early and blood sugar levels are properly controlled, it is possible to stop the progression at an early stage.
If left untreated, it can eventually cause blindness. As a result, it is necessary to see an ophthalmologist and an internal medicine specialist regularly, as well as to monitor and properly control your blood sugar levels.
0 Comments