Diabetic macular edema (DME) is swelling in the retina caused by diabetic retinopathy. More specifically, the swelling is located in the macula, the functional center of the retina. Diabetic Macular Edema Occurs In Almost Everyone DME is the most common "side effect" or complication of diabetic retinopathy. It should not be feared, but rather, it should be … [Read more...]
Retinal Ischemia: Supply vs. Demand
May 4, 2010 By 2 Comments
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...]
Lasers for “Eye Surgery”
January 26, 2010 By Leave a Comment
There are many lasers and many ways to use lasers in eye surgery. I am asked all the time if I perform "laser surgery," but I know what they are asking. While I do perform laser surgery for diabetic retinopathy, and (not so much anymore) macular degeneration, they are really asking if I perform laser vision correction eye surgery. No, I don't. There are at least 5 different areas of … [Read more...]
Eye Injections Challenge Eye Laser for Diabetic Retinopathy
December 3, 2009 By Leave a Comment
There is a small study just published in the journal "Ophthalmology" stating that intraocular injections of Lucentis® were superior to laser photocoagulation for the treatment of diabetic macular edema. As you read this, don't forget that the "gold-standard" for treatment of diabetic macular edema is still laser photocoagulation. These "studies" are very small and not of the caliber needed to … [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...]
Laser Treatment for Diabetic Retinopathy Still The Best: True Cases
September 24, 2009 By 1 Comment
I saw two patients (RJ and JR) yesterday that have the same "problem." They both are patients with diabetes and both have advanced, or proliferative, diabetic retinopathy. Both have had diabetes for over 20 years, are on insulin and have been treated with pan-retinal photocoagulation to control the proliferative diabetic retinopathy. Both still have 20/20 vision. Neither have ever … [Read more...]
