These include injections, laser treatment, and eye surgery:
To understand what happens during diabetic retinopathy surgery it’s necessary to understand a little more about the disease. During the first stage, or early-stage (nonproliferative diabetic retinopathy, or NPDR) the blood vessels that supply the retina become weakened. Small bulges appear that can leak blood. The vessels dilate (widen), some become blocked, and the nerve fibers can swell. The macula (the central area of the retina) can also become filled with fluid—this is called macula edema.
The second, more advanced stage (proliferative diabetic retinopathy, PDR) leads to the damaged blood vessels becoming closed off completely. New vessels grow to compensate but these are abnormal in size and shape. They bleed easily and leak into the vitreous (the clear jelly within the eye). Scar tissue forms and, if not treated, can cause the retina to detach from the back of the eye. Pressure can increase within the eye, damaging the optic nerve. This can lead to glaucoma.
Treatments used to treat worsening diabetic retinopathy include:
Laser treatment: There are different types of laser treatment. The first is called photocoagulation, or focal laser treatment. It stops or reduces the leakage of blood vessels by sealing them with a laser burn. The second type is panretinal photocoagulation, or scatter laser treatment. This uses a laser to shrink the abnormal blood vessels, so preventing them from leaking. This treatment is carried out over multiple sessions. All laser treatments are generally carried out under local anesthetic and take around 30-40 minutes per session.
Eye injections: These are used to treat severe diabetic maculopathy, a condition where the central part of the retina becomes damaged. The injections, called VEGF inhibitors (vascular endothelial growth factor) or anti-VEGF help prevent the growth of new, abnormal blood vessels and swelling in the eye. The treatment is quick and usually pain-free. It will initially be carried out once a month until vision stabilizes. After this, they may be more infrequent or stopped altogether. In some cases, if VEGF treatment fails to have an effect, steroid medications may be injected instead.
Eye surgery: Known as vitreoretinal surgery, this is carried out when a large amount of blood has leaked into the eye or if extensive scar tissue has, or is likely to, cause retinal detachment. It involves making a small incision and removing some of the vitreous from the eye. It’s carried out under local anesthetic with sedation, so is pain-free and you’ll be unaware of it being carried out.
