Diabetic Retinopathy - Treatment Overview
There is no cure for diabetic retinopathy. But laser treatment (photocoagulation) is usually very effective at preventing vision loss if it is done before the retina has been severely damaged. Surgical removal of the vitreous gel (vitrectomy) may also help improve vision if the retina has not been severely damaged. Sometimes injections of an anti-VEGF (vascular endothelial growth factor) medicine or an anti-inflammatory medicine help to shrink new blood vessels in proliferative diabetic retinopathy. Because symptoms may not develop until the disease becomes severe, early detection through regular screening is important. The earlier retinopathy is detected, the easier it is to treat and the more likely vision will be preserved. You may need treatment for diabetic retinopathy if: It has affected the center (macula) of the retina. Abnormal new blood vessels have started to appear. Your side (peripheral) vision has been severely damaged. If the macula has been damaged by macular edema, anti-VEGF medicine, such as Lucentis, may help. Steroids may be injected into the eye. Sometimes an implant, such as Iluvien, may be placed in the eye to release a small amount of corticosteroid over time. If the retina hasn't been severely damaged, laser treatment or vitrectomy may help with macular edema. Surgical removal of the vitreous gel (vitrectomy) is done when there is bleeding (vitreous hemorrhage) or retinal detachment, which are rare in people with early-stage retinopathy. Vitrectomy is also done when severe scar tissue has formed. Treatment for diabetic retinopathy is often very effective in preventing, delaying, or reducing vision loss. But it is not a cure for the disease. People who have been treated for diabetic retinopathy need to be monitored frequently by an eye doctor to Continue reading >>
Reverse Diabetic Retinopathy With Easy In Home Treatment
Introductory EWOT Articles An Easy Way to Get Oxygen For Multi-Step Therapy (EWOT) Regain or Maintain Your Youth with EWOT! The Real Cause of Cancer and the Only Way to Stop It. Multistep Oxygen Therapy - The Best Antiaging Gift You Can Give your Body Reverse Diabetic Retinopathy with Easy In Home Treatment Advanced EWOT Articles Coming Soon! EWOT Studies Yes EWOT has been studied worldwide. We will be posting EWOT Studies on our site. Please check back to see them! Reverse Diabetic Retinopathy With Easy, In Home Treatment (EWOT!) Written by: Robert Rowan MD; Read more at www.docRowen.com. Also read about Ozone in Sierra Leone and Vaccines at FaceBook.com/DrRobertJRowen. You can reverse the two most feared complications from diabetes, retinopathy and nephropathy, with a simple treatment you can do in your own home. Both of these conditions develop in diabetics because the disease causes the capillary membranes to thicken. When these membranes thicken, it hinders oxygen and nutrient delivery to the cells. Unfortunately, conventional medicine has little to offer diabetics who develop these conditions. Most of them receive laser surgery, with little success. But a new study gives evidence that diabetics, even those who have had laser surgery, can benefit from one of my favorite therapies. In a pilot study just published by Johns Hopkins Hospital, five patients between the ages of 52 and 69 with diabetic retinopathy were selected. All had conventional laser treatment previously and 9 of 10 eyes had persistent edema despite the laser. (Lasers burn abnormal and leaking blood vessels caused by diabetes in the retina.) The patients were given supplemental oxygen (using an oxygen concentrator) at four liters per minute by nasal tube. They were instructed to use the oxygen contin Continue reading >>
Retinopathy
What Is It? Retinopathy means that disease has damaged the retina. The retina is the part inside the eye that senses light. Different diseases can cause retinopathy. There can be partial or complete loss of vision. Retinopathy can develop slowly or suddenly, can get better on its own or lead to permanent damage. The retina contains many blood vessels. Abnormalities in these vessels are a major cause of retinopathy. There are several types of retinopathy, including: Retinopathy of prematurity (ROP). ROP occurs in some infants who are born prematurely or at a low birth weight. When a child is born too early, retinal blood vessels do not have time to finish growing properly. In the early stages of ROP, there are only subtle changes and no obvious symptoms. In more advanced stages, the retina can become detached, causing blindness. Diabetic retinopathy. Diabetic retinopathy develops in people with type 1 or type 2 diabetes. It takes years to develop. Two kinds of diabetic retinopathy have the potential to diminish vision: In nonproliferative retinopathy, blood vessels in the retina deteriorate. Deteriorating blood vessels can become blocked or deformed. Fluids, fats and proteins leak out of the abnormal blood vessels. Fluid can collect in the retina. This swelling impairs sharp vision. In proliferative retinopathy, new, structurally unstable blood vessels grow on the surface of the retina. These unstable blood vessels cause frequent minor bleeding. The bleeding causes local irritation and scarring. Proliferative retinopathy can cause retinal detachment. This is a separation of the layers of the retina. It is one of the most serious consequences of proliferative retinopathy. The vitreous is the clear gel between the lens and the retina. Sudden bleeding into the vitreous can Continue reading >>
What Treatments Are Available For Diabetic Eye Disease?
The first step in any treatment for diabetic eye disease is to maintain blood glucose, blood pressure, and blood cholesterol levels as close to normal as possible. Treatment of diabetic macular edema (swelling or the accumulation of blood and fluids in the macula, the part of the retina that provides sharp central vision), has evolved a great deal in the last five to ten years, and is based on the severity of the edema. At present, there are three options: laser treatment Avastin, Lucentis, or Eylea injection intravitreal steroids: Kenalog, Ozurdex, and Iluvien Laser Treatment This technique is used by retinal surgeons to treat a number of eye conditions, one of which is diabetic eye disease. A beam of high-intensity light is directed into the eye to seal off leaking blood vessels and prevent additional blood and fluid from leaking into the vitreous, which is the jelly-like substance that fills the inside of the back part of the eye. The doctor administers eye drops to dilate (open up) the pupil and numb the eye before treatment begins. Because lasers cannot restore lost vision, it is critical to maintain regular comprehensive eye examinations so that treatment can be initiated as soon as diabetic eye changes are detected. There are two types of laser treatments for diabetic eye disease: Focal laser treatment, also called photocoagulation: The retina is treated to stop or slow the leakage of blood and fluid from abnormal blood vessels within the eye. Focal laser, however, can also destroy surrounding healthy retinal tissue as it seals the leakage from abnormal blood vessel growth; therefore, it is not used on blood vessels directly under the macula, the center of the retina. Scatter laser treatment, also called panretinal photocoagulation: The areas of the retina away f Continue reading >>
Eye Problems And Diabetes
Eye problems and diabetes introduction If you have diabetes, regular visits to your ophthalmologist for eye exams are important to avoid eye problems. High blood sugar (glucose) increases the risk of diabetes eye problems. In fact, diabetes is the leading cause of blindness in adults age 20 to 74. If you have eye problems and diabetes, don't buy a new pair of glasses as soon as you notice you have blurred vision. It could just be a temporary eye problem that develops rapidly with diabetes and is caused by high blood sugar levels. High blood sugar in diabetes causes the lens of the eye to swell, which changes your ability to see. To correct this kind of eye problem, you need to get your blood sugar back into the target range (90-130 milligrams per deciliter or mg/dL before meals, and less than 180 mg/dL one to two hours after a meal). It may take as long as three months after your blood sugar is well controlled for your vision to fully get back to normal. Blurred vision can also be a symptom of more serious eye problem with diabetes. The three major eye problems that people with diabetes may develop and should be aware of are cataracts, glaucoma, and retinopathy. A cataract is a clouding or fogging of the normally clear lens of the eye. The lens is what allows us to see and focus on an image just like a camera. Although anyone can get cataracts, people with diabetes get these eye problems at an earlier age than most and the condition progresses more rapidly than in people without diabetes. If you have a cataract, there is a cloudy area in the lens of your eye that results in the inability to focus light, and your vision is impaired. Symptoms of this eye problem in diabetes include blurred or glared vision. During cataract surgery, the cloudy lens is removed or cleaned ou Continue reading >>
Diabetic Retinopathy Treatment
Tweet Retinopathy can lead to blindness but the good news is that it can be treated, especially if retinopathy progression is caught at an early stage. It is likely that if you have had diabetes for a number of years, you may be at an early stage of having retinopathy. It is therefore important to attend a retinopathy screening appointment each year. Treating background retinopathy Background retinopathy, also known as non-proliferative retinopathy, is when there are signs of retinopathy but not significant enough to need treatment to the eyes. In background retinopathy, some of the blood vessels in the retina may become blocked, swollen or have leaked but in most cases this won’t disrupt vision and won’t present symptoms. Treating background retinopathy involves keeping blood glucose, blood pressure and blood lipid levels well managed. Typical health targets for people with diabetes are: HbA1c: achieve 48 mmol/mol or below (6.5% or below) Blood pressure: achieve 130/80 mmHg or below Blood lipids: achieve total cholesterol levels of less than 4 mmol/l and triglyceride levels of below 1.7 mmol/l Note that a rapid improvement in blood glucose levels, a decrease in HbA1c of 30 mmol/mol (3%), may result in a worsening of retinopathy. Adopting a healthy diet and taking regular physical activity is important in achieving these goals. If you struggle to meet the health targets, your health team may prescribe stronger medication or suggest a different insulin regimen. Treating maculopathy Maculopathy occurs if retinopathy causes damage to the blood vessels around the macula, the part of the eye responsible for our central vision and ability to see detail. Such damage includes oedema, when fluid builds up in blood vessels causing them to swell and can result in protein leaki Continue reading >>
Diabetic Retinopathy
How the Eye Sees NPDR Macular Edema-Ischemia Fluorescein Angiography OCT Laser for Macular Edema PDR PRP PDR Anti-VEGF Vitreous Hemorrhage Ultrasound Vitrectomy If you have diabetes, you are at risk to develop Diabetic Retinopathy. Regular eye examinations with your ophthalmologist are very important. By maintaining strict control of your blood sugar levels, you will significantly lower your risk of vision loss. Diabetic Retinopathy is the result of damage caused by diabetes to the small blood vessels located in the retina. The retina is the light-sensitive tissue at the back of the eye. Blood vessels damaged from Diabetic Retinopathy can cause vision loss. In some people with Diabetic Retinopathy, blood vessels may swell and leak fluid. In others, abnormal new blood vessels grow on the surface of the retina. A healthy retina is necessary for good vision. If you have Diabetic Retinopathy, at first you may not notice changes to your vision. But over time, Diabetic Retinopathy can get worse and cause vision loss. Diabetic Retinopathy usually affects both eyes. Symptoms include: Blurred vision and gradual vision loss Floaters and flashers Shadows or missing areas of vision Difficulty seeing well at night Other problems that may develop are: Macular Edema – the macula is the area of the retina that provides sharp vision straight in front of you. If fluid leaks into this area, vision will become more blurry. Retinal Detachment -scarring may cause part of the retina to pull away from the back of the eyeball A comprehensive eye examination by your doctor is the only way to find any changes in your eyes. An ophthalmologist can usually diagnose and treat serious Retinopathy before you are aware of any vision changes. The doctor will dilate your pupil and examine the inside of Continue reading >>
Diabetic Retinopathy
All people with diabetes are at risk of developing diabetic retinopathy. Vision loss or blindness may be preventable through early detection and timely treatment. Good control of diabetes, blood pressure and cholesterol as well as regular eye examinations may prevent vision loss. It is important to take action before you notice any eye problems. On this page: Diabetic retinopathy is a complication of diabetes that damages blood vessels inside the retina at the back of the eye. Regular eye exams will reduce the risk of vision loss and blindness caused by diabetic retinopathy. Laser treatment is used successfully to treat retinopathy. All people with diabetes are at risk of developing diabetic retinopathy. Types of diabetic retinopathy There are three main types of diabetic retinopathy: Non-proliferative retinopathy is an early form of the disease, where the retinal blood vessels leak fluid or bleed. Macular oedema is a swelling of the macula, caused by the leakage of fluid from retinal blood vessels. It can damage central vision. Proliferative retinopathy is an advanced form of the disease and occurs when blood vessels in the retina disappear and are replaced by new fragile vessels that bleed easily, and that can result in a sudden loss of vision. Retinopathy is a high risk for diabetics It is important to understand your risk of diabetic retinopathy. Anyone with diabetes is at risk of developing retinopathy. People with diabetes (type 1 and type 2) are 25 times more likely to experience vision loss than people without diabetes. Without treatment, diabetic retinopathy can cause loss of vision and blindness. Unfortunately, only half of the people with diabetes have regular eye exams, and one-third have never been checked. Symptoms There are no early-stage symptoms of diab Continue reading >>
Diabetic Retinopathy
- Did you know that diabetes is the most common cause of blindness in individuals from the ages of 25 to 65? And blindness can be caused by multiple different complications associated with diabetes including glaucoma and cataracts, however in this tutorial, let's discuss the most common cause of blindness due to diabetes which is a condition known as diabetic retinopathy. And if we break down the term, we can receive generally, an understanding of what this disease is, so you have retino here meaning the retina, and pathy meaning disease. So, diabetic retinopathy is a disease of the retina that's caused by diabetes. And to describe what the retina is, let's bring in a diagram of the eye and go through some of the structures as it will help us as we learn more about this condition. Over here on the left, we have a cross-section of the eye and there's a few important structures to note. So this is the front of the eye here, and this is the back of the eye, and this part right here is known as the cornea. And it is where light initially passes through as it goes through the eye, and then it hits this structure right here, which is known as the lens. And the lens focuses the light on this structure in the back of the eye, this kind of brownish structure, and this is the retina. And then exiting the back of the eye here, this is the optic nerve. Then, you can also see all of these blood vessels that are traveling through the retina and then exit the back of the eye in the middle of the optic nerve. So if you look over here on the right, this is a front view of the eye. So this is kind of what it looks like when a doctor looks in to your eye. So here, right here we have what's called the optic disc, and the optic disc is really just the convergence of the retina and where it Continue reading >>
Can Diabetic Retinopathy Be Reversed?
Sindre, you are confronting something very difficult. I have had type 1 diabetes for over 40 years as well. My experience might be helpful. I learned to not assign the role of primary care giver to my doctors some 36 years ago when I came across an article in the Journal of Chronic Disease on the correlation of tight control and the side effects of diabetes. The article excited me because it showed me that there was something I could do about the problems of diabetes. However, it also infuriated me that my doctors had never told me about any such thing as a side effect. (We did have an animated discussion after that.) Then a few years later in the late 70s I was one of the participants in a study on the use of an insulin pump and in home blood testing. The pump was the size of a brick and I had to go to a saddle maker to have a holster made for it. In that small study one of the participants saw a dramatic reduction in his very advanced diabetic neuropathy. So good control is critical and that was the first I had known about the possibility of reversal of the “irreversable”. This tool gave me the power to do something about my condition to keep it from being a disease. So to this day I have no side effects of diabetes. My opthamologist told me a few years ago that he had never seen a diabetic beyond 10 years with no retinopathy. OK now for what this has to do with your father’s situation is this; I became my own primary care giver when I found that the doctors were going to prescribe a progression of drugs on top of the insulin without looking for any cure. No I do not expect the T1 diabetes to be reversed by diet but the disease portion of diabetes such as enhanced coronary artery disease, neuropathy, retinopathy, renal failure et al are preventable and reversibl Continue reading >>
Reversing My Diabetic Retinopathy
Sarah, also known as Sugabetic in the diabetes community, has lived with type 1 diabetes for almost 27 years! A long time. She’s a wife, a mother of two healthy kiddos, and one the best people to ask when it comes to weighing the differences between different insulin pumps, glucose meters, and CGMs…because she’s tried them all! In 2014, Sarah was diagnosed with “mild non-proliferative diabetic retinopathy (NPDR).” In a nutshell, NPDR is the milder form of PDR, which is the more severe progression of diabetic retinopathy. Both NPDR and PDR are eye conditions diagnosed when blood vessels within the retina have “changed,” explains the diabetic eye doctor: Normal retinal blood vessels are watertight and do not leak. In diabetes, the retinal blood vessels can become damaged and develop tiny leaks. This is called nonproliferative diabetic retinopathy (NPDR). Blood and fluid seep from the leaks in the damaged retinal blood vessels, and fatty material (called exudate) can deposit in the retina. This causes swelling of the retina. When leakage occurs and causes swelling in the central part of the retina (the macula), it is called macular edema, and vision will be reduced or blurred. Leakage elsewhere in the retina will usually have no effect on vision. For people with diabetes, retinopathy can occur as a result of high blood sugars over the years or it can also occur in a person who has maintained very normal blood sugar levels but simply has a predisposition to developing retinopathy or other diabetes complications. Thanks to major developments and leaps forward in today’s medical technology, people with diabetes who catch the signs of NPDR early enough are presented with a tremendous opportunity: treatments that can actually reverse the damage that has occurred Continue reading >>
Diabetic Retinopathy
Diabetic retinopathy (pronounced ret in OP uh thee) is a complication of diabetes that causes damage to the blood vessels of the retina— the light-sensitive tissue that lines the back part of the eye, allowing you to see fine detail. Diabetic retinopathy is the most common cause of irreversible blindness in working-age Americans. As many people with type 1 diabetes suffer blindness as those with the more common type 2 disease. Diabetic retinopathy occurs in more than half of the people who develop diabetes. Video: Vision Treatment Breakthrough: People With Diabetic Eye Disease Have a New Option That Could Preserve or Improve Their Vision Symptoms It is possible to have diabetic retinopathy for a long time without noticing symptoms until substantial damage has occurred. Symptoms of diabetic retinopathy may occur in one or both eyes. Symptoms may include: Blurred or double vision Difficulty reading The appearance of spots— commonly called “floaters”— in your vision A shadow across the field of vision Eye pain or pressure Difficulty with color perception Causes The primary cause of diabetic retinopathy is diabetes—a condition in which the levels of glucose (sugar) in the blood are too high. Elevated sugar levels from diabetes can damage the small blood vessels that nourish the retina and may, in some cases, block them completely. When damaged blood vessels leak fluid into the retina it results in a condition known as diabetic macular edema which causes swelling in the center part of the eye (macula) that provides the sharp vision needed for reading and recognizing faces. Prolonged damage to the small blood vessels in the retina results in poor circulation to the retina and macula prompting the development of growth factors that cause new abnormal blood vessels Continue reading >>
Diabetic Retinopathy Treatment
Before covering the Diabetic Retinopathy Treatment, let us start overseeing the condition. Diabetic Retinopathy is a disease of the retina. Many people who have diabetes will eventually get Diabetic Retinopathy. The retina is the layer of the eye that is directly in the back of the eye. The retina sends the images that are seen to the brain. Diabetic Retinopathy can cause vision failure and lead to blindness. It usually gets worse over time. It affects the blood vessels in the eye causing them to weaken, which can lead to blood and liquids leaking into the retina. This is the common type of Diabetic Retinopathy. Causes of Diabetic Retinopathy Diabetes can result in damage of the small blood vessels throughout the body. This reduces the flow of blood. If the lessened blood flow affects the tiny blood vessels in the eye, the result is Diabetic Retinopathy. Tiny blood vessels weaken and the blood vessels may burst. New blood vessels then grow on the surface of the retina, and these fragile vessels may also break and bleed into the eye, resulting in cloudy vision and the development of scar tissue. Symptoms of Diabetic Retinopathy It is possible to have Diabetic Retinopathy for a long time without being aware of it. The condition does not have symptoms that are easily noticed until significant damage has already been done to the eye, so that the patient is in need for a Diabetic Retinopathy Treatment. Typical symptoms include: Blurred or distorted vision Difficulty reading Floaters in the eye affecting vision Partial or total loss of vision or shadow over field of vision Pain occurring in the eye As the Diabetic Retinopathy Symptoms gets worse and more fluid and proteins leak it will cause the retina to swell. This causes mild to severe vision loss. If the swelling affects Continue reading >>
Diabetic Retinopathy Treatment & Management
Approach Considerations Controlling diabetes and maintaining the HbA1c level in the 6-7% range are the goals in the optimal management of diabetes and diabetic retinopathy. If the levels are maintained, then the progression of diabetic retinopathy is reduced substantially, according to The Diabetes Control and Complications Trial. [11] The Early Treatment for Diabetic Retinopathy Study [21] has found that laser surgery for macular edema reduces the incidence of moderate visual loss (doubling of visual angle or roughly a 2-line visual loss) from 30% to 15% over a 3-year period. Two-year results from the Diabetic Retinopathy Clinical Research network (DRCR.net) Randomized Trial Evaluating Ranibizumab Plus Prompt or Deferred Laser or Triamcinolone Plus Prompt Laser for Diabetic Macular Edema, known as the Laser-Ranibizumab-Triamcinolone for DME Study, demonstrated that ranibizumab paired with prompt or deferred focal/grid laser treatment achieved superior visual acuity and optical coherence tomography (OCT) outcomes compared with focal/grid laser treatment alone. In the ranibizumab groups, approximately 50% of eyes had substantial improvement (10 or more letters) and 30% gained 15 or more letters. Intravitreal triamcinolone combined with focal/grid laser did not result in superior visual acuity outcomes compared with laser alone, but did appear to have a visual acuity benefit similar to ranibizumab in pseudophakic eyes. [26] The Diabetic Retinopathy Study has found that adequate scatter laser panretinal photocoagulation reduces the risk of severe visual loss (< 5/200) by more than 50%. [22] Continue reading >>
Diagnosis
Print Diabetic retinopathy is best diagnosed with a dilated eye exam. For this exam, drops placed in your eyes widen (dilate) your pupils to allow your doctor to better view inside your eyes. The drops may cause your close vision to blur until they wear off, several hours later. During the exam, your eye doctor will look for: Abnormal blood vessels Swelling, blood or fatty deposits in the retina Growth of new blood vessels and scar tissue Bleeding in the clear, jelly-like substance that fills the center of the eye (vitreous) Retinal detachment Abnormalities in your optic nerve In addition, your eye doctor may: Test your vision Measure your eye pressure to test for glaucoma Look for evidence of cataracts Fluorescein angiography With your eyes dilated, your doctor takes pictures of the inside of your eyes. Then your doctor will inject a special dye into your arm and take more pictures as the dye circulates through your eyes. Your doctor can use the images to pinpoint blood vessels that are closed, broken down or leaking fluid. Optical coherence tomography Your eye doctor may request an optical coherence tomography (OCT) exam. This imaging test provides cross-sectional images of the retina that show the thickness of the retina, which will help determine whether fluid has leaked into retinal tissue. Later, OCT exams can be used to monitor how treatment is working. Treatment Treatment, which depends largely on the type of diabetic retinopathy you have and how severe it is, is geared to slowing or stopping progression of the condition. Early diabetic retinopathy If you have mild or moderate nonproliferative diabetic retinopathy, you may not need treatment right away. However, your eye doctor will closely monitor your eyes to determine when you might need treatment. Work with Continue reading >>
