Laser treatment for diabetic retinopathy
Laser treatment is highly effective in halting the progression and at times even reversing some of the complications of diabetic retinal disease. It has been the mainstay of treatment for decades, and Dr. Clark has been performing laser treatment for over 25 years.
Focal and/or grid macular laser aims to close leaking microaneurysms in the blood vessels which cause swelling in the center of the retina, leading to decreased visual acuity in both non-proliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR). It is also felt to work by stimulating areas of growth in the retinal pigment epithelium just behind the leaky retina, and these enhanced areas of tissue then resorb more of the leaking fluid back into the bloodstream.
Pan-retinal photocoagulation, or PRP, is used in proliferative diabetic retinopathy (PDR). In PDR, abnormal blood vessels are growing in response to growth factors put out by unhealthy retinal tissue. These blood vessels eventually bleed and cause scarring, leading to blindness. PRP laser works by purposely sacrificing the unhealthy tissue to reduce the amount of blood vessel growth factors being produced. When the stimulus for growth of the abnormal blood vessels is thus reduced, they stop growing, shrink, and even disappear.
Currently, laser is still used in the treatment of diabetic retinopathy, although various injectable medications now play an equally important, if not more important, role. Oral medications are also being researched.