diabetic retinopathy treatment

Diabetic Retinopathy Treatment

Diabetic Retinopathy Treatment & Laser at Center for Sight serving Fall River, Massachusetts and greater Providence, Rhode Island

By Robert Kelly, M.D.

Today, we know that all diabetics need to have regular eye exams because with early and aggressive treatment of diabetic retinopathy it is possible to maintain vision and prevent severe vision loss for many patients.  Depending on the stage of Diabetic Retinopathy, the potential for and the amount of vision loss, it is possible to treat, stabilize and often reverse the effects of the disease. Treatment of Diabetic Retinopathy can entail the use retinal laser photocoagulation treatment as well as intravitreal injections of Vascular Endothelial Growth Factor (VEGF) Inhibitor drugs or other drugs.  However, successful management of diabetic eye problems requires early diagnosis and treatment.

The National Institutes of Health and the National Eye Institute have funded a number of large scale, multi-center, controlled studies that have produced clinical care guidelines for Diabetic Retinopathy used our physicians. These include:

Early Treatment Diabetic Retinopathy Study (ETDRS)

Diabetes Control and Complications Trial (DCCT)

Diabetic Retinopathy Study (DRS)

Diabetic Retinopathy Vitrectomy Study (DRVS)

We use the results of these studies to guide patients in the treatment of Diabetic Retinopathy since with early treatment it is possible for patients with Diabetic Retinopathy to have only half the likelihood of losing vision as compared to those patients who fail to receive early treatment.

These studies have produced treatment guidelines indicating which patients may benefit from various treatment options to preserve vision and delay progression of vision loss.  Dr. Kelly uses the results of these studies to guide patients in the treatment of Diabetic Retinopathy since with early treatment it is possible for patients with diabetic retinopathy to have only half the likelihood of losing vision as compared to those patients who fail to receive early treatment.

Diabetic Laser Treatment

  • Nonproliferative Retinopathy & Laser Treatment
    During the early stages of Mild Nonproliferative Retinopathy, Moderate Nonproliferative Retinopathy and Severe Nonproliferative Retinopathy, it is unlikely that you will need Laser Treatment, unless you have Diabetic Macular Edema.

    However, in order to prevent the progression of Diabetic Retinopathy it is quite important to maintain good overall health.  First, rigid control of blood sugar levels is key for protecting the health of the small blood vessels.  Patients should work to reduce any and all risk factors for vascular disease including controlling their blood pressure, not smoking, reducing dietary fat consumption to lower cholesterol and trigycerides and exercising regularly.
  • Proliferative Retinopathy & Laser Treatment
    Proliferative Retinopathy is treated with a Retinal Laser Eye Surgery procedure called Panretinal Photocoagulation or “Scatter Laser Treatment”.  The goal of Scatter Laser Treatment is to shrink abnormal blood vessels.  Dr. Kelly places 1,000 to 2,000 laser spots in areas of the Retina away from the Macula, causing the abnormal blood vessels to shrink.  Since Scatter Laser Treatment requires a large number of laser spots, Dr. Kelly will use two or more sessions to complete the treatment.

    Sometimes patients who have had Scatter Laser Photocoagulation will experience some loss of your side or peripheral vision, some loss of night vision and a decrease in color vision.  Scatter Laser Treatment is necessary to preserve the rest of your vision and stop the progression of the disease.

    Scatter Laser Treatment works best when it is applied before the fragile, new blood vessels have started to bleed.  This is why it is critical to have regular, comprehensive dilated eye exams.  Even when bleeding has started, Scatter Laser Treatment may still be possible, depending on the amount of bleeding.
  • Diabetic Macular Edema & Laser Treatment
    Diabetic Macular Edema is best treated with one or both of two types of Laser Eye Surgery procedures: “Focal Laser Treatment” and “Grid Laser Treatment.”  Focal Laser treatment is used to close leaking microanuerysms in a limited area and Grid Laser treatment is used to treat a more general swelling in the Macula.

    With either Laser Treatment, Center for Sight Retinal Specialist Robert Kelly, M.D. will place as many as several hundred laser spots in the areas of retinal leakage surrounding the Macula.  These spots act to slow the leakage of fluid and reduce the amount of fluid in the Retina.  It is usually possible to complete these Laser Treatments in one session, however, depending on the results, additional treatment may be necessary.

    You may need to have Laser Treatment for Macular Edema more than once to control the leaking fluid.  If you have Macular edema in both eyes and require laser surgery, generally only one eye will be treated at a time, usually several weeks apart.

    Laser treatment of Diabetic Macular Edema works to stabilize vision. In fact, Laser Treatment may reduce the risk of vision loss by 50 percent.  In a small number of cases, if vision is lost, it may be improved.

What to Expect During Diabetic Laser Treatment
Your Diabetic Laser Eye Surgery will be performed in our office at Center for Sight by Retinal Specialist Robert Kelly, M.D. To prepare you for Diabetic Laser Eye Surgery eye drops will be placed in your eye to dilate your pupil, and to numb your eye and minimize any discomfort.  The lighting in the laser suite will be dimmed and you will find a comfortable seated position facing the Laser. Dr. Kelly will gently hold a special lens to your eye to help focus the Laser. During the treatment you should expect to see flashes of light that may be associated with some stinging sensation that may be a bit uncomfortable.  After your treatment you will need someone to drive you home.  You should also bring a pair of sunglasses, as your eyes will still be dilated after the laser treatment. During the remainder of the day of your treatment, your vision may be somewhat blurry.  If there is more than mild discomfort, you should call our office and Dr. Kelly will able to make suggestions as needed.

If you have been diagnosed with diabetes or even if you are just glucose intolerant, you should have a thorough diabetic eye examination and ongoing examinations for Diabetic Retinopathy at Center for Sight as with early intervention and treatment the potential for vision loss can be significantly reduced. Please call us in Fall River, Massachusetts at 508-730-2020.

Center for Sight is conveniently located for diabetic patients in need of evaluation, diagnosis and treatment of diabetic retinopathy in Massachusetts or Rhode Island from Attleboro, Fairhaven, Fall River, Franklin, Mansfield, Marion, Mattapoisett, Medfield, Milford, New Bedford, North Attleboro, North Dartmouth, Norton, Oxford, Rehoboth, Somerset, Swansea, Taunton, Walpole, Whitinsville, Woonsocket, Providence, Smithfield, Westport, Lakeville, Dighton, Little Compton and Tiverton.