Retinal ischemia causes VEGF to be liberated inside the eye. In cases of diabetes this can lead to diabetic retinal detachment or neovascular glaucoma. Treatments included pan-retinal photocoagulation (laser) or anit-VEGF medication such as Lucentis or Avastin. Ischemia results when oxygen supply does not meet oxygen demand to any tissue. Other examples are the heart and legs. With … [Read more...]
Neovascularization Causes Blindness
February 15, 2010 By 16 Comments
Both macular degeneration and diabetic retinopathy can cause "blindness" from neovascularization. Both are diseases of the retina, both can lead to "blindness," both increase with age/time and both can be associated with abnormal blood vessel formation known as "neovascularization." The two diseases differ in the location of the neovascularization. Diabetic Retinopathy - In cases of … [Read more...]
Avastin: An Adjunctive Therapy for Proliferative Diabetic Retinopathy
January 27, 2010 By 11 Comments
Avastin® is useful for a variety of eye conditions; it is principally used to treat wet macular degeneration and is becoming a popular option to treat diabetic macular edema. On occasion, Avastin has also been useful, in my practice, to treat patients with proliferative diabetic retinopathy. VEGF (Vascular Endothelial Growth Factor) also causes abnormal blood vessels to grow in cases of … [Read more...]
Blood in the Eye: You Make the Call
January 8, 2010 By Leave a Comment
Last week another long time patient of mine (as most are with diabetic retinopathy and macular degeneration) returned with complaints of the sudden onset of floaters in the left eye. The floaters had been present for about one month, they hadn't cleared and he made an appointment. I've added this illustration that resembles what I saw after dilating his pupils. What do you … [Read more...]
VEGF Causes Blindness in Diabetes and Macular Degeneration
December 14, 2009 By 3 Comments
Vascular Endothelial Growth Factor is implicated in both diabetic retinopathy and wet macular degeneration. Anti-VEGF medications, such as Macugen®, Lucentis® and Avastin® have changed the way we handle both diseases. This week we'll review VEGF and the three key anti-VEGF medications. What is VEGF? Vascular Endothelial Growth Factor (VEGF) is a substance that is produced in the eye. … [Read more...]
Tree Bark May Be Beneficial To Diabetics: Supplement or Drug?
December 11, 2009 By 2 Comments
"Ever Eat A Pine Tree? Many Parts are Edible." That famous line by Euell Gibbons lives on. Now, "researchers" have described that Pycnogenol®, an extract from the bark of the French maritime pine tree, has the potential to improve vision in patients with diabetic retinopathy. The tree is found along the coast of southwest France. In a small study involving 46 patients with early … [Read more...]
Retina Laser Treatment Saves Vision
December 1, 2009 By 3 Comments
There are two conditions where laser treatment is needed in patients with diabetic retinopathy: macular edema and evidence of proliferative retinopathy. In cases where macular edema, swelling of the retina in the macular area, is present, "focal" photocoagulation is needed. In cases of proliferative diabetic retinopathy, "pan-retinal photocoagulation," or PRP, is needed. Focal Laser … [Read more...]
Laser Treatment Still The Best
November 13, 2009 By 1 Comment
Laser treatment for diabetic macular edema is still the preferred treatment for most patients with diabetic retinopathy. Despite all the recent news about intraocular injections of anti-VEGF and steroid medications, the laser remains the mainstay. The most common manifestation of diabetic retinopathy is the development of macular edema (also known as diabetic macular edema (DME) or clinically … [Read more...]
