Treatment for diabetic retinopathy is often delayed until it starts to progress to Proliferative Diabetic Retinopathy (PDR), or when diabetic macular edema occurs. People with severe non-proliferative diabetic retinopathy have a high risk of developing PDR and may need a comprehensive dilated eye examination as often as every twp to four months.
Diabetic retinopathy can be treated with several therapies, used alone or in combination.
Scatter Laser Therapy
For decades, PDR has been treated with scatter laser therapy known as panretinal photocoagulation. Treatment involves making 2000 to 3000 tiny laser burns in areas of the retina away from the macula. These laser burns are intended to cause abnormal blood vessels to shrink. Although treatment can be completed in one session, two or more sessions are sometimes required. While it can preserve central vision, scatter laser surgery may cause some loss of side (peripheral), colour, and night vision. Scatter laser surgery works best before new, fragile blood vessels have started to bleed.
Anti-Angiogenesis Injection Therapy
Anti-VEGF drugs are injected into the vitreous gel to block a protein called vascular endothelial growth factor (VEGF), which can stimulate abnormal blood vessels to grow and leak fluid. Available anti-VEGF drugs include Avastin (bevacizumab), Lucentis (ranibizumab), and Eylea (aflibercept).
Recent studies have shown that anti-Vascular Endothelial Growth Factor (VEGF) treatment not only is effective for treating diabetic macular edema, but is also effective for slowing progression of diabetic retinopathy, including PDR, so anti-VEGF is increasingly used as a first-line treatment for PDR.