Medication
Laser Treatment for Diabetic Retinopathy. If you have diabetic retinopathy, your doctor may use a type of laser treatment called scatter laser surgery as part of your treatment plan. You may also need other treatments, like injections, in addition to laser treatments. Learn more about diabetic retinopathy.
Procedures
Depending on the specific problems with your retina, options may include: 1 Photocoagulation. This laser treatment, also known as focal laser treatment,... 2 Panretinal photocoagulation. This laser treatment, also known as scatter laser treatment,... 3 Vitrectomy. This procedure uses a tiny incision in your eye to remove blood from the middle...
Self-care
Conventional laser photocoagulation has numerous applications in the treatment of retinal disease, including diabetic retinopathy, retinal vein occlusions, sickle cell retinopathy, and retinal tears.
Nutrition
In cases of active PDR in eyes previously treated with PRP, additional laser burns can be placed in nontreated areas or between existing burns. Laser has become second-line therapy for center-involved DME, as it has been replaced by intravitreal injections of anti-VEGF and steroidal agents.
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How do you treat diabetic retinopathy with laser?
What is the best treatment for retinal detachment?
What are the applications of laser photocoagulation for retinal disease?
What is the second-line therapy for diabetic retinopathy (DME)?
What is the best treatment for diabetic retinopathy?
laser treatment – to treat the growth of new blood vessels at the back of the eye (retina) in cases of proliferative diabetic retinopathy, and to stabilise some cases of maculopathy. eye injections – to treat severe maculopathy that's threatening your sight.
What is laser treatment for diabetic retinopathy called?
If you have advanced diabetic retinopathy, your doctor may use a type of laser treatment called scatter laser surgery as part of your treatment plan.
What is Panretinal photocoagulation?
Panretinal photocoagulation (PRP) is a mainstay of therapy for retinal ischemic disease. The procedure involves creating thermal burns in the peripheral retina leading to tissue coagulation, the overall consequence of which is improved retinal oxygenation.
What is laser photocoagulation used for?
Laser photocoagulation is a type of laser surgery for the eyes. It is done to treat age-related macular degeneration (AMD). AMD is a condition that can lead to loss of vision. The retina is the layer of cells in the back of your eye that converts light into electrical signals.
Why is vitrectomy performed?
Vitrectomy is a surgical procedure undertaken by a specialist where the vitreous humor gel that fills the eye cavity is removed to provide better access to the retina. This allows for a variety of repairs, including the removal of scar tissue, laser repair of retinal detachments and treatment of macular holes.
What is a vitrectomy done for?
A vitrectomy is a type of eye surgery to treat various problems with the retina and vitreous. During the surgery, your surgeon removes the vitreous and replaces it with another solution. The vitreous is a gel-like substance that fills the middle portion of your eye.
Which laser is used in Panretinal photocoagulation?
According to DRS protocol using a standard argon-type laser PRP, settings include burns that range approximately 200μ to 500μ in size, pulse durations of 100 milliseconds, and 200-250 mW of power. The goal is to produce burns that are grey in color; and avoid dense white burns.
When do you use Panretinal photocoagulation?
Panretinal Photocoagulation (PRP) is a type of laser treatment for the eye. It is used in people who have developed new abnormal blood vessels at the back of the eye in the retina or in the drainage system within the eyeball.
What type of laser is used for retinal surgery?
Retinal tears and holes Today, the majority of retinal tears are treated in the eye doctor's office through a process called laser photocoagulation. Typically, argon lasers are used. They emit light energy to “weld” the edges of a retinal tear or hole against the underlying tissue lining the back of your eye.
What is fluorescein angiography used for?
This test is done to see if there is proper blood flow in the blood vessels in the two layers in the back of your eye (the retina and choroid). It can also be used to diagnose problems in the eye or to determine how well certain eye treatments are working.
Abstract
This review highlights indications and evidence on laser therapy in the management of diabetic retinopathy and diabetic macular edema.
Introduction
Laser (Light Amplification by Stimulated Emission of Radiation) therapy is utilized widely in nearly all fields of medicine including ophthalmology, particularly in the treatment of retinal vascular diseases such as proliferative diabetic retinopathy (PDR), diabetic macular edema (DME), retinal vein occlusions, central serous chorioretinopathy, choroidal neovascularization, and vascular tumors [ 1 ].
How Does Retinal Laser Therapy Treat Diabetic Eye Disease?
The principle of retinal laser therapy resulting in therapeutic effects in the target retinal tissue is based upon the absorption of light by ocular pigments, predominantly in the retinal pigment epithelium (RPE) and choroid [ 9, 10] melanin and hemoglobin.
Conventional Photocoagulation
Conventional laser photocoagulation has numerous applications in the treatment of retinal disease, including diabetic retinopathy, retinal vein occlusions, sickle cell retinopathy, and retinal tears.
Modern Scanning Laser Photocoagulation
As laser technology has evolved and improved over the last several decades, emphasis has been placed on developing modifications to conventional retinal laser therapy in order to minimize retinal damage and adverse side effects, while maintaining the excellent therapeutic effect of the conventional approach.
Selective Retinal Therapy
As noted above, conventional retinal photocoagulation is limited in its use for macular conditions because of the risk of vision loss from central scars (resulting in scotomas) and expansion of the laser scar over time.
Subthreshold Diode Micropulse Laser
Subthreshold diode micropulse (SDM) laser is another novel laser modality for photocoagulation designed to minimize collateral tissue damage for treatment of the macula.
What is the treatment for diabetic retinopathy?
Depending on the specific problems with your retina, options might include: Injecting medications into the eye. These medications, called vascular endothelial growth factor inhibitors, are injected into the vitreous of the eye.
How to diagnose diabetic retinopathy?
Diagnosis. Diabetic retinopathy is best diagnosed with a comprehensive dilated eye exam. For this exam, drops placed in your eyes widen (dilate) your pupils to allow your doctor a better view inside your eyes. The drops can cause your close vision to blur until they wear off, several hours later. During the exam, your eye doctor will look ...
What is the name of the drug that is injected into the vitreous of the eye?
These medications, called vascular endothelial growth factor inhibitors, are injected into the vitreous of the eye. They help stop growth of new blood vessels and decrease fluid buildup. Two drugs are approved by the U.S. Food & Drug Administration (FDA) for treatment of diabetic macular edema — ranibizumab (Lucentis) and aflibercept (Eylea). ...
What is the procedure to shrink blood vessels?
Panretinal photocoagulation. This laser treatment, also known as scatter laser treatment, can shrink the abnormal blood vessels. During the procedure, the areas of the retina away from the macula are treated with scattered laser burns. The burns cause the abnormal new blood vessels to shrink and scar.
How often should diabetics get eye exams?
If you have any level of retinopathy, you'll need eye exams at least annually. Ask your eye doctor what he or she recommends.
How long does it take to get an eye exam for diabetes?
The American Diabetes Association (ADA) recommends that people with type 1 diabetes have an eye exam within five years of being diagnosed. If you have type 2 diabetes, the ADA advises getting your initial eye exam at the time of your diagnosis.
What is the purpose of OCT test?
This will help determine how much fluid, if any, has leaked into retinal tissue. Later, OCT exams can be used to monitor how treatment is working.
How many treatment options are there for diabetic retinopathy?
Generally speaking there are five treatment options for diabetic retinopathy: Healthy Lifestyle. Laser Treatment.
What is the best treatment for diabetic macular edema?
These anti-VEGF drugs include Lucentis and Eylea. Both are FDA approved for the treatment of diabetic macular edema. Anti-VEGF drugs are injected directly into the retina during a simple outpatient procedure. Depending on the severity of your condition, you may require multiple injections spread over several months.
What is the drug that inhibits blood vessel growth?
The abnormal blood vessel growth associated with diabetic retinopathy is tied to a specific protein called vascular endothelial growth factor (VEGF). There are a number of drugs that target VEGF to inhibit abnormal blood vessel growth. These anti-VEGF drugs include Lucentis and Eylea. Both are FDA approved for the treatment of diabetic macular edema.
What is the laser used for?
Laser treatments can be used to target the abnormal blood vessel growth responsible for diabetic retinopathy. Blood vessel leaks can be closed (cauterized) using targeted laser energy (photocoagulation) in some cases, or the laser may be used to target and destroy the abnormal blood vessel network. This procedure is called grid laser ...
What is the most common eye condition in people with diabetes?
Diabetic retinopathy is the most common diabetic eye condition and the leading cause of blindness in people with diabetes, according to the National Eye Institute (NEI).
Can you drive home after laser treatment?
You will need to arrange for someone to drive you home after treatment given that short-term vision may be compromised. Although laser treatment can be effective in helping to limit vision loss caused as a result of diabetic retinopathy, it’s important to keep in mind that it usually does not improve vision.
Can a diabetic eye doctor treat diabetes?
A primary treatment for diabetic eye disease targets the diabetes itself. A healthy lifestyle which maintains proper blood sugar levels can go a long way toward blunting the overall progression of diabetes, and its associated diseases like diabetic retinopathy. Your ophthalmologist can communicate with your internal medicine specialists if he or she has any questions about the treatment strategy for overall health maintenance in the face of your diabetic condition.
How to perform vitrectomy for diabetic retinopathy?
People with diabetic retinopathy may require vitrectomy surgery in an operating room setting. A vitrectomy is performed when there is bleeding or retinal traction that is causing loss of vision in people with advanced diabetic retinopathy. In this surgical procedure, small instruments are inserted into the eye under microscopic visualization, and both the vitreous hemorrhage and any scar tissue are removed. Laser photocoagulation may be performed at the time of surgery, and in some cases, a gas bubble or silicone oil may be placed to hold the retina in position if there are retinal holes or detachment. The prognosis for people who require vitrectomy surgery depends upon the status of the underlying diabetic retina.
What is vitrectomy surgery?
A vitrectomy is performed when there is bleeding or retinal traction that is causing loss of vision in people with advanced diabetic retinopathy. In this surgical procedure, small instruments are inserted into the eye under microscopic visualization, and both the vitreous hemorrhage and any scar tissue are removed.
What is laser photocoagulation?
Laser photocoagulation is a well-established treatment for diabetic retinopathy. A laser delivers a split-second burst of intense light energy to treat leaky retinal blood vessels or promote shrinkage of abnormal blood vessels (neovascularization). Laser photocoagulation has been proven in large clinical trials to significantly reduced the risk of both moderate and severe vision loss in people with diabetic retinopathy.
Diabetic retinopathy is a serious sight-threatening complication of diabetes that can lead to blindness
This ocular disease is caused by high levels of sugar in the bloodstream and results in progressive damage to the light detecting retina responsible for sending visual signals to the brain.
A closer look at how diabetes affects the eyes
Diabetes is a condition that prevents the body from using and storing sugar properly. As a result, excessive amounts of sugar remain in the bloodstream and cause damage to the smallest blood vessels all over the body— including your eyes.
Types of diabetic retinopathy
Non-Proliferative Retinopathy (NPR), also called Background Retinopathy, is the earliest stage of the disease. In this stage, high blood sugar concentration in the retina causes microaneurysms, in which damage to the walls of the tiny retinal capillaries occurs.
Symptoms of diabetic retinopathy
Diabetic retinopathy usually does not present symptoms in its early stages, so by the time the symptoms are noted it is essential to seek medical care.
How is diabetic retinopathy diagnosed?
It is crucial for people with diabetes to have comprehensive eye exams on a regular basis, to detect signs of the disease even before symptoms are noticed.
How is diabetic retinopathy treated?
Treatment for diabetic retinopathy depends on the stage of the disease.
Factors that may increase your risk of diabetic retinopathy
The longer you have had diabetes, the higher your risk of developing diabetic retinopathy.
What is the best treatment for diabetic macular edema?
In recent years, intravitreal anti- VEGF injections have become popular as treatments for diabetic eye disease, and their safety and efficacy have been demonstrated in clinical trials. Anti-VEGF injections have shown superiority over laser for several indications in diabetic eye disease, and they are easy to administer and provide rapid improvement in vision. All of this has caused many ophthalmologists to prefer anti-VEGF injections over laser, and as a result, laser has become a second-line therapy for these indications.
How to apply PRP without macular edema?
The best way to apply PRP without causing macular edema is to divide it into two sessions or more. I usually do PRP in two sessions 2 weeks apart. In cases of active PDR in eyes previously treated with PRP, additional laser burns can be placed in nontreated areas or between existing burns.
What type of laser is used for DME?
In general, there are two types of laser waves: continuous wave (CW) and subthreshold diode micropulse (SDM) laser.
Which wavelength of PRP is used for retinal burns?
With these wavelengths, PRP should be applied with the least power necessary to induce retinal burns and with a large window of treatment. In contrast, infrared laser (810 nm), which can be painful to the patient, requires higher energy with a smaller window of treatment.
How thick should a retinal laser be before treatment?
If a 532-nm laser is to be used, retinal thickness should be reduced to 400 µm or less before treatment. A single-spot navigated laser system or a pattern scanning laser can be helpful in performing laser treatment for DME.
What wavelength is used for ophthalmic lasers?
There are four main types of laser wavelengths in commercially available ophthalmic lasers: 577, 532, 670, and 810 nm. There is also a vast array of wide-field lenses available, and there are two methods of application—using slit-lamp biomicroscopy or indirect ophthalmoscopy. Yellow (577 nm) and green (532 nm) lasers are ...
Is laser photocoagulation a first line treatment?
Laser photocoagulation is still first-line therapy in the management of PDR, as described in the ETDRS more than 25 years ago. 3 However, following certain guidelines can pave the way to better outcomes.
Diagnosis
Treatment
Clinical Trials
Alternative Medicine
Specialist to consult
Coping and Support
- Diabetic retinopathy is best diagnosed with a comprehensive dilated eye exam. For this exam, drops placed in your eyes widen (dilate) your pupils to allow your doctor a better view inside your eyes. The drops can cause your close vision to blur until they wear off, several hours later. During the exam, your eye doctor will look for abnormalities in...
Preparing For Your Appointment
- Treatment, which depends largely on the type of diabetic retinopathy you have and how severe it is, is geared to slowing or stopping the progression.