The eye works like a camera. It has two parts, a lens and a film. The film layer lines the back wall of the eyes and is called the retina. It has arteries that provide it blood flow and veins which drain the blood. Diabetic changes are characterized by outpouching of normal blood vessels called microaneurysms and areas of bleeding within the retina called dot blot hemorrhages. Patients with severe diabetic retinopathy have extensive areas of bleeding throughout the retina.
This condition has a 50% chance of progressing to a vision threatening condition called proliferative diabetic retinopathy within 12 months. Furthermore, patients with severe diabetic retinopathy are at increased risk of losing vision from swelling within the retina.
Lucentis is a medication which can decrease bleeding, lower the risk of developing a vision threatening condition called proliferative diabetic retinopathy, and decrease the risk of swelling within the retina.
Lucentis is injected into the eye every month for a period of 3-6 months. Afterwards, the time between injections is increased to every 2-4 months. The total number of injections that each patient requires varies. Your eye care specialist will customize the treatment to the way your eye responds to the medication.
The main risk of the procedure is the development of an infection called endophthalmitis. Fortunately, the risk of this infection is very low, occurring in approximately 1 in 3000 injections. Patients can decrease their risk of developing an infection by avoiding rubbing, touching their eyes, or allowing water into their eyes for at least one week.
Please review information on the intravitreal injection procedure for more helpful details. There will be no graphic photos or images.
Most patients undergoing this treatment are surprised that the injection may be administered in a painless manner.
What can patients do to decrease their risk of diabetic eye disease worsening?
Here are the goals from the perspective of an ophthalmologist:
Maintain a hemoglobin A1C of 7 or less. This is an average blood sugar of 154.
Maintain a blood pressure of 140/90 or less
What should patients watch out for between visits?
The new onset of worsening blurry vision may be a sign of increased swelling in the retina. We ask patients to contact their eye care specialist if they note worsening vision as this may be a sign that treatment is needed sooner than the next scheduled visits.
The onset of many new floaters or decreased vision may be a sign of new bleeding. This is treatable but does require you to contact your eye care specialist.
Why is it important to follow-up with your eye care specialist?
Untreated swelling in the retina can cause permanent vision loss if present for weeks to months without treatment.
Abnormal new blood vessels may bleed and temporarily decrease vision. Your eye care specialist may be able to detect these in the early stage and initiate treatment to decrease the risk of vision loss.
Most patients with severe non-proliferative diabetic retinopathy will continue to see well during their lifetime if they are vigilant about controlling their blood sugar levels and follow-up regularly with their eye care specialist.
I hope you found this information helpful.
Please reach out to your eye care specialists if you have additional questions or concerns.
