Laser Deemed Best Treatment for Diabetic Retinopathy

This press release is an announcement submitted by HealthDay News, and was not written by Diabetes Health.

Standard therapy still recommended over steroid injections, researchers say

| Jan 1, 2010

THURSDAY, Dec. 31 (HealthDay News) -- Steroid injections into the eye slowed diabetes-related eye disease, though lasers remain the treatment of choice because of side effects related to the steroids, new research shows.

Researchers from the Johns Hopkins Wilmer Eye Institute gave 693 men and women who had diabetic retinopathy with macular edema either injections of a corticosteroid into their eyes as often as every four months or a laser photocoagulation, the standard treatment. The average age of the participants was 63.

Retinopathy is a long-term complication of diabetes that can lead to blindness. Macular edema, which can further interfere with vision, is a swelling of the central portion of the retina caused by fluid leakage.

Over time, retinopathy can advance to proliferative diabetic retinopathy, in which abnormal blood vessels grow on the optic nerve in the back of the eye, which communicates information from the retina to the brain, or elsewhere on the light-sensitive retina. The study authors found that steroid treatments reduced the risk of progression of diabetic retinopathy.

However, steroids did not prevent the progression of macular edema, according to the study.

And while steroids did help to improve the vision of participants, the results were no better than the laser treatments. Because the use of steroids in the eye can increase the risk of other eye diseases, including glaucoma and cataracts, lasers remain the treatment of choice for now, said lead study author Neil Bressler, a professor of ophthalmology and chief of the retina division of the eye institute.

"Steroid treatment worked, but because of safety issues, cannot be recommended routinely at this time," Bressler said in a news release from the institute. "It is a condition that can be treated safely and effectively with lasers."

The study findings are published in the December issue of Archives of Ophthalmology.

About 700,000 Americans have proliferative diabetic retinopathy, and 63,000 new cases develop each year, according to background information provided in the news release.

Corticosteroids may slow the progression of retinopathy by reducing the production of compounds that promote the growth of harmful new blood vessels, the researchers said.

More research is needed to determine if steroids can be used without increasing the risk of glaucoma or cataracts, the authors said.

More information

The U.S. National Eye Institute has more on diabetic retinopathy.

http://www.healthday.com/Article.asp?AID=634464

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Categories: Diabetes, Diabetes, Eye Care (Retinopathy), Health Care, Type 1 Issues, Type 2 Issues


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Comments

Posted by Anonymous on 6 January 2010

The thought of having injections in the eye is a bit intimidating, to say the least.

I've had laser treatment for proliferative retinopathy, and yes, it hurts but I don't think that I could stomach the thought of multiple injections in the eye.

I think that I'd have to really be sedated for that type of procedure.

Thank goodness that laser is still the preferred standard.

Posted by Randall_Wong_MD on 13 January 2010

I am a retina specialist/ophthalmologist.

A well written article and I understand the comment and concern regarding injections. Please let me clarify the present treatments;

1. Laser is used in two ways for diabetic retinopathy. One laser is to control macular edema, the most common complication of diabetic retionpathy. It does not hurt and has been standard therapy for years.

Newer treatments involving steroid injections for the macular edema are challenging the viability of laser, but at this time, as the study points out, the steroid injection do control the macular edema, but do NOT slow down the disease.

In the future, injections involving sustained release/long acting steroids will be available and probably will become the mainstay of treatment.

2. Proliferative diabetic retinopathy is that stage of diabetic retinopathy that leads to blindness. The traditional therapy has been a second type of laser that can, and usually does, hurt. This is reflected in the above "comment."

For now, laser (panretinal photocoagulation) is the preferred method. Eventually there may be "injections" involving anti-VEGF (vascular endothelial growth factor) that may actually work better than laser.

I give the intraocular injections daily. I assure you that they are painless.

I know what your are saying to yourself, but I mean it, they don't hurt.

Hope this was helpful and not too confusing.

Randall V. Wong, M.D.
www.RetinaEyeDoctor.com


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