- Laser Photocoagulation Treatment
This involves shining a laser beam through a contact lens placed on the eye. The laser beam creates small burns on the retina to seal off abnormal blood vessels to stop it from leaking. This also prevents new vessels from growing. The whole process is usually spread out over 2-3 sessions. It does not require hospitalization and is usually not painful. The vision may be a bit blur for 1-2 days. After the whole process, the patient may experience some loss of side or night vision. Laser treatment may not restore vision that has been lost. However, this is essential to prevent further visual loss and eventual blindness.
When some bleeding inside the eye occurs, a procedure in the operating theatre called vitrectomy may be necessary to restore vision. This is a retina surgery where fine instruments are used to remove the blood from inside the eye. This also helps to remove scar tissue and treat retinal detachment. An air bubble may be injected at the end of the procedure to keep the eye in the normal shape. This may require the patient to maintain a facedown posture for a few days until the gas bubble disappears. Surgery usually implies a late stage of diabetic retinopathy has occurred and aims mainly to prevent further visual loss.
This is a recently discovered new group of drugs, called anti-VEGF (anti-Vascular Endothelial Growth Factor). By injecting the drug directly into the eye using a small, fine needle, it has been shown to be effective in a condition called Age-related Macular Degeneration by causing regression of the abnormal blood vessels. This has been also been used in patients with diabetic retinopathy. It can control retina swelling and prevent further bleeding in the eye. This is promising treatment that may result in improvement of vision but results vary between individuals. However, injections may have to be repeated on a monthly basis for optimal results.An example of this agent isLucentis (ranibizumab) (www.lucentis.com). Due to the high cost of Lucentis, a close chemical alternative of Lucentis, Avastin (bevacizumab) can be used.Avastin is a drug used for patients with colorectal cancer. It is used ‘off-label’ for patients who cannot afford Lucentis. Both of these drugs are injected directly into the eye known as an intravitreal injection.