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Diabetic Retinopathy

Definition: The deterioration of retinal blood vessles, called diabetic retinopathy, can lead to vision loss. Although considered one disease, there are many types of diabetic retinopathy. The two main categories are nonproliferative (when blood vessels leak and/or close) and proliferative (new blood vessels grow, or proliferate) retinopathy. Non-Proliferative Retinopathy:
  • Macular edema due to focal leakage: Localized areas of swelling and/or lipid deposits in or near the fovea.
  • Early nonproliferative: May have leakage in areas of the retina outside the fovea.
  • Macular edema due to diffuse leakage: Leakage is scattered throughout the macula, causing swelling.
  • Preproliferative: Capillaries close, setting the stage for new blood vessel growth.
Proliferative Diabetic Retinopathy:
  • Early Proliferative: Weak blood vessels grow to replace ones that have closed up.
  • Severe bleeding: New blood vessels rupture and bleed into the vitreous.
  • Traction retinal detachment: New blood vessels and scar tissue grow from the retina onto the vitreous and may pull (traction) on the retina and detach it.
Treatment: Different levels of severity of diabetic retinopathy and different areas of the retina involved merit different treatments. Sometimes injectable medications like Avastin, Lucentis, Eylea, or Kenalog are used. Laser photocoagulation treatment can often stop or slow the progression of diabetic retinopathy and safely and reliably stabilize or improve vision. By focusing the laser onto diseased areas in the retina, swelling can be reduced, closed vessels destroyed, and weak vessels sealed. Laser can be used in three patterns:
  • Focal laser treatment is used to treat macular edema due to focal leakage.
  • Grid laser treatment is used to treat macular edema due to diffuse leakage.
  • Panretinal laser treatment may be used to treat preproliferative and proliferative retinopathy.
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Everyone, and especially those with diabetes, should have an eye exam every year to monitor for eye disease and vision changes.

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