Diabetic retinopathy is a common complication of diabetes. High blood sugar levels can damage blood vessels in the retina. The retina is the light sensitive layer at the back of the eye, akin to the film of a camera. Diabetic retinopathy is more common with increased duration of diabetes. Poorly controlled risk factors such as uncontrolled hypertension, elevated blood sugar and elevated blood lipids also contribute to the development of diabetic retinopathy.
There are two types of sight threatening diabetic retinopathy. Leakage from diseased blood vessels, if it occurs in the centre of the retina (the macula) can cause serious loss of vision. This is called diabetic macular oedema. This affects principally fine or reading vision. Abnormal blood vessels can bleed and a very serious cause of visual loss in diabetes. This condition is called proliferative diabetic retinopathy.
Mild diabetic retinopathy will not usually require any treatment, other than controlling risk factors and taking preventative measures such as:
- Attending your annual screening appointment
- Informing your GP if you notice any changes to your vision
- Taking your prescribed medication
- Losing any excess weight and eating a healthy balanced diet
- Exercising regularly
- Giving up smoking
- Controlling your blood pressure and cholesterol levels
Treatment for Diabetic Retinopathy
There are three main treatments for diabetic retinopathy which are Laser treatment, injections into the eye or surgery. Your ophthalmic surgeon will be able to tell you, which treatment is needed.
Laser treatment is used for diabetic macular oedema and proliferative retinopathy.
If there is fluid in the retina, which is threatening the centre of vision, laser can be used to dry up the leaking blood vessels. It may need to be repeated. Laser is very effective and the effect is usually permanent. Laser cannot be used for all patients who have fluid in the centre of the eye. If the fluid is underneath the centre, laser could damage the eye sight. In this situation, injections into the eye are considered.
Laser treatment is used to control abnormal blood vessels. Laser needs to be performed on multiple occasions, over a prolonged period of time. The abnormal blood vessels, shrink and disappear, there is no longer a threat to vision. Laser does cause scarring in the retina. However, if the new abnormal blood vessels persist, the threat to vision is very severe.
Intravitreal injections mean an injection into the eye. The drugs used are called VEGF antagonists. The two licenced drugs for this purpose are ranibizumab (lucentis) and aflibercept (eyelea). These drugs are highly effective in the treatment of diabetic retinopathy. The advent of these medications has transformed the outlook in what were very serious, blinding eye conditions.
The drugs are used for patients with fluid at the centre of the eye. The fluid dries up and vision very often improves. The injections may be combined with laser treatment. Injections may need to be repeated on numerous occasions.
Intravitreal injections are also useful for treatment of abnormal blood vessels or proliferative diabetic retinopathy. They are given in conjunction or as a supplement to laser photocoagulation.
Will I need a referral from my GP or Optician?
For treatment of diabetic retinopathy you will need to be referred by your GP or optician before you book a consultation.
What to do next
Contact the eye centre team to book a consultation with one of our consultant ophthalmic surgeons who will aim to provide you with all the information you need before you embark on your treatment including choice of procedures, what they involve and the associated risks and benefits. You should allow an hour for your consultation. The guide price for a consultation ranges from £200 to £250. Investigations including optical coherence tomography may be indicated.
How much does it cost?
The exact cost will depend on the treatment you require which will be confirmed at your initial consultation.
If you have medical insurance, you may be covered for payment of this procedure. Please check with your insurer to confirm. If you are paying for treatment yourself, we have interest free finance - 0% representative APR available. Download our information flyer or contact the friendly eye centre team for more details.