The diabetic patient should know that the most important thing he can do for his illness is to properly regulate his blood glucose. The deregulated glucose leads to DR faster. He should also regulate blood pressure, his hyperlipidemia (cholesterol and triglycerides) if present and limit smoking and alcohol.
LASER: The loss of vision can be prevented laser beam treatment, if this is performed at the right time.
This is applied when ischemic regions are formed in the retina, or mainly when new pathological vessel start to form. The new vessels are sensitive and can cause hemorrhages.
Laser helps to eliminate pathological blood vessels, thus preventing possible hemorrhage and loss of vision.
Early diagnosis and even the treatment of proliferative retinopathy or macular edema may reduce the risk of blindness by 90%.
It should be emphasized that laser is primarily intended to save the vision that is left, not to improve it, although there are cases where improvement is possible.
The treatment is painless and is done with a few sessions. Side effects are minor, they mainly concern the reduction of the visual field but nothing compared to the risk of someone losing his sight without treatment.
The laser treatment is divided into panretinal photocoagulation, which requires 2-3 sessions for the treatment to be applying to all the fundus of the eye, except for the central area and focal laser, which is applied to diabetic macular edema in order to reduce it.
The Athens Eye Hospital offers all kinds of laser, which are chosen as appropriate.
Photocoagulation in diabetic retinopathy is performed with the Argon Green Laser and the hospital has two laser systems, the Pascal Argon laser (Optimedica) and the green photocoagulator (532 nm Novus ® Verdi ®).
The intravitreal cortisone injection is a treatment method for diabetic macular edema with very good results. The effect of the drug lasts for 6 weeks and in case of recurrent swelling another injection is required. The use of cortisone is associated with the formation of cataracts in eyes that have not had cataract surgery, as well as increasing intraocular pressure and glaucoma.
In recent years, new drugs are being used to treat edema, such as antiangiogenic factors (AVASTIN, LUCENTIS), with very good results and without the side effects of cortisone. The effects of these drugs last 4-8 weeks and must be repeated at recurrence. The specialist ophthalmologist chooses the combination of injections and focal laser, as appropriate.
In certain cases surgery treatment is required. The procedure used is the vitrectomy, ie the removal of the vitreous (gel) that fills the eye, which in advanced diabetic retinopathy causes vitreous hemorrhage, tractional and/or rhegmatogenous retinal detachment, preretinal and subretinal hemorrhages, diffuse macular swelling macula with a strong vitreomacular traction + / - subclinical macular detachment.
The Athens Eye Hospital has an exemplary vitrectomy unit (Baush & Lomb, Stellaris PC) with the most complete equipment in the field and a specialized medical team to treat the most difficult circumstances. The procedures are performed under local anesthesia with instillation of anesthetic drops. Our department pioneers in performing suture-free vitrectomy.