Diabetic Retinopathy Diagnosis
Your Visual Acuity will be assessed using the Snellen eye chart which measures how well each eye can see. From there, our team in Stuart will determine which diabetic retinopathy treatments will be best for you. A detailed history of your blood sugar variations will be obtained. Drops are put in your eye that help to widen (dilate) the pupils. Then, using a special magnifying lens, your eye doctor will look at your retina.
Specialized imaging tests may be ordered to better assess the health of the retina. The Ocular Coherence Tomographer, (OCT) scans through your dilated pupil to assess the quality of the retinal tissue, reflecting areas damaged by diabetes. In Fluorescein Angiography (FA), a special dye is injected into a vein in your arm and as the dye passes through the blood vessels in your retina, pictures are taken of the back of your eye. This test allows an eye doctor to see the circulation of the retina, which is critical to assessing the level of damage to the retina from diabetes.
CIRRUS HD-OCULAR COHERENCE TOMOGRAPHER (OCT)
We have the newest CIRRUS HD-Ocular Coherence Tomographer (OCT) scans through your dilated pupil to assess the quality of the macula and surrounding retinal tissue, reflecting damaged areas and in the case of Wet Macular Degeneration – fluid. This test shows the different layers of the retina and gives almost a biopsy-like image using light.
Optical Coherence Tomography Angiography (OCTA) is the newest non-invasive technology that is used for imaging blood vessels. OCTA provides both structural and functional (i.e. blood flow) information simultaneously in a fast and easily repeatable way. It uses laser light reflectance of the surface of moving red blood cells to accurately image retinal and choroidal vessels. One advantage of this OCT-based approach is that it provides a quantitative analysis of the blood vessels in addition to the qualitative analysis done on standard angiography. It also allows accurate localization of a pathology due to the precise segmentation provided by this technology. OCTA can be used to evaluate common ophthalmologic diseases such age related macular degeneration (AMD), diabetic retinopathy, artery and vein occlusions, and glaucoma.
INDOCYANINE GREEN (ICG) ANGIOGRAPHY
Indocyanine Green (ICG) Angiography, a procedure similar to Fluorescein angiography, uses Indocyanine green dye, which can show more detail than Fluorescein angiography.
DIABETIC RETINOPATHY TREATMENT OPTIONS
Careful observation of the diabetic patient on a regular basis by an eye doctor is crucial in detecting Diabetic changes. There often is no decrease in vision, though damage from diabetes may be occurring.
As with many diseases, our doctors in Port St. Lucie and Stuart have found that the best diabetic retinopathy treatment is prevention. Strict control of your blood sugar will significantly reduce the long-term risk of vision loss from diabetic retinopathy. Laser surgery is often recommended for people with Diabetic Macular Edema, Proliferative Diabetic Retinopathy, and Neovascular Glaucoma.
LASER SURGERY FOR MACULAR EDEMA
For Macular Edema, the laser is focused on the damaged retina near the macula to decrease fluid leakage. Some may see laser spots near the center of their vision following treatment; usually fade with time, but may not disappear. It is uncommon for people who have blurred vision from macular edema to recover normal vision, although some may experience partial improvement. The main goal of treatment is to prevent further loss of vision.
LASER SURGERY FOR PROLIFERATIVE DIABETIC RETINOPATHY
For Proliferative Diabetic Retinopathy, the laser is focused on all parts of the retina except the macula. This “pan retinal” photocoagulation treatment causes abnormal new vessels to shrink; often prevents them from growing again. Treatment decreases the chance that vitreous bleeding or retinal distortion will occur. Multiple laser treatments over time are sometimes necessary.
At our offices in Port St. Lucie and Stuart, we also offer vitrectomy surgery to some of our patients. Vitrectomy Surgery for advanced Proliferative Diabetic Retinopathy is needed when the vitreous (white, gel-like substance in middle of eye) fills with blood. Performed in the operating room, this microsurgical procedure involves removing the blood-filled vitreous and replacing it with a clear solution. This invasive surgery often prevents further bleeding by removing abnormal vessels that caused bleeding, by additionally treating the eye with laser treatment.
For certain patients, Anti-VEGF treatment (Avastin, Lucentis, Eylea and Beovu) is now a great treatment in controlling Macular Edema and Proliferative Diabetic Retinopathy. We help develop most of these new treatments. Call our office to find out if this treatment option may be right for you.