Treatment of Diabetic Retinopathy

How does Diabetic Retinopathy occur?

‘Diabetic retinopathy’ caused by diabetes is the most common reason for blindness between the age of 20-65. If it isn’t treated, the risk of blindness is 25 times more than people who don’t have diabetes. The main reason for problems on retina is impairments of retinal vessels due to diabetes.

As a result of these impairments; while it may be seen microaneurysms (bubbles in small vessels) on retina, bleedings, edema (aggregation of water), exudate (accumulations due to the leakage from the vessels) at an early stage of disease, at the later stages of the disease it may be encountered not reaching adequate oxygen (ischemia) to the neural layer, formation of the new vessels and membranes.

At the last stage of the disease, blindness may occur as the severe results of bleedings into the eye, of separating the retinal layer from the eyewall (retinal detachment) by the membranes. Therefore, proper follow-up and treatment and early diagnosis are very important. With today’s modern technology, the rate of blindness in these patients can be reduced below %5 percentage.

When the patients are diagnosed with diabetes for the first time, they must be examined by an ophthalmologist and they must continue their follow-ups as frequent as the doctor suggested without a break for more than a year. If it is required by an ophthalmologist, eye angiography may be performed during these examinations. This procedure performed seated after administrating an iv drug through the armed vessel takes a couple of minutes and with this procedure, the place of the leakage on retina, ischemia, forming of new vessels are examined in detail. In our clinic, screening without using a virtual angiography-OCT is possible. In addition to this, the other examination method used frequently is optical coherence tomography (OCT). With this method, it is possible to examine the retinal layer at the 5-10 micron level in seconds.

The main aim of the treatment for diabetic retinopathy is keeping the current vision stable. For this purpose, the most used treatment method is laser surgery. Laser surgery is a painless intervention. With this intervention, it is aimed to reduce the edema on the retina and to regress the newly formed vessels tending to bleed. In our clinic, treatment can be performed by the micropulse (cold laser) as the most modern technology without damaging the neural cells that provide vision. This laser technology can be used many times as it does not damage the cells.

Intraocular drug administration can be performed in cases in which laser treatment is not adequate. A surgical operation may be needed in advanced cases. With the vitrectomy operation in which high technology is used and which is performed by an experienced surgeon,  bleeding in the eye and membranes are cleaned, and a separated retinal layer is replaced. Gas or silicon may be placed into the eye at the end of the operation.