Diabetic Retinopathy

Diabetic Retinopathy

When Diabetes affects retina, it is termed Diabetic retinopathy. Diabetic retinopathy is of three types:

1. Background Diabetic retinopathy (BDR) (early stage)
2. Proliferative Diabetic retinopathy (PDR) (late stage)
3. Diabetic maculopathy (central)

In very early stages of Diabetic retinopathy,no treatment is required however if the changes are significant fluorescein angiography is performed and based on its interpretation,laser treatment is given to the patient. In very early stages of diabetic retinopathy where fluorescien angiography has not been done, patients are advised to keep blood suger under strict control and undergo fundas examination every 6 months so that as per requirement treatment can be planned.

The stage of diabetic retinopathy wherein new vessels are formed on retina is known as PDR. Here, after fluorescien angiography laser photocoagnlation is requyired. Laser prevents progression of diabetic retinopathy. Sometimes in PDR,there is vitreous haemorrhage (Blood in get like structure infront of retina) and this causes sudden diminution in vision. Vitreous haemorrhage tends to absorb spontaneously over a period of few weeks but if it doesn't resolve, then it needs surgical intervention.

In some patients of diabetic retinopathy, only central part is affected and this is known as diabetic maculopathy. Any patient with diabetic maculopathy has difficulty to read small letters. diabetic maculopathy is also treated by laser. the aim of laser treatment being prevention of progression of maculopathy.

Any patient of diabetic retinopathy must keep his blood sugar under control.

Drugs that can be used in diabetic retinopathy

In recent years a group of drugs called Anti-VEGF(vasucular emdothelicol growth factor) have been developed. These help prevent the formation of abnormal blood vessels that occur in proliferative diabetic retinopathy. They include:

• Ranibizumab(Lucentis)
• Bevacizumab(Avastin)
• Begaptanib(Macugen)

These drugs are injected directly into vitreous cavity.these may be repeated with in 4-6 weeks if needed.'So they help prevent progression of the diseases & may restore some of the vision.