There are three major treatments for<unk> , which are very effective in reducing vision loss from this disease. In fact, even people with advanced retinopathy have a 95 percent chance of keeping their vision when they get treatment before the retina is severely damaged. These three treatments are laser surgery, injection of corticosteroids or anti-VEGF agents into the eye, and vitrectomy. Although these treatments are very successful (in slowing or stopping further vision loss), they do not cure<unk> . Caution should be exercised in treatment with laser surgery since it causes a loss of retinal tissue. It is often more prudent to inject triamcinolone or anti-VEGF<unk> ugs. In some patients it results in a marked increase of vision, especially if there is an edema of the macula. Although commonly used in some parts of the world, it is unclear whether herbal medicine (for example, Ruscus extract and Radix Notoginseng extract) are of benefit to people with<unk> . Avoiding tobacco use and correction of associated hypertension are important therapeutic measures in the management of<unk> . Obstructive sleep apnea (OSA) has been associated with a higher incidence of<unk>  eye disease due to blood desaturation caused by intermittent upper airway obstructions. Treatment for OSA can help reduce the risk of<unk>  complications. The best way of preventing the onset and delaying the progression of<unk>  is to monitor it vigilantly and achieve optimal glycemic control. Since 2008 there have been other therapies (e.g. kinase inhibitors and anti-VEGF)<unk> ugs available. Laser photocoagulation Laser photocoagulation can be used in two scenarios for the treatment of<unk> . Firstly, It can be used to treat macular edema which was common before eye injections were introduced. and secondly, it can be used for treating whole retina (panretinal photocoagulation) for controlling neovascularization. It is widely used for early stages of proliferative retinopathy. There are different types of lasers and there is evidence available on their benefits to treat proliferative<unk> . Modified grid laser A 'C' shaped area around the macula is treated with low intensity small burns. This helps in clearing the macular edema. Panretinal Panretinal photocoagulation, or PRP (also called scatter laser treatment), is used to treat proliferative<unk>  (PDR). The goal is to create 1,600 – 2,000 burns in the retina with the hope of reducing the retina's oxygen demand, and hence the possibility of ischemia. It is done in multiple sittings. In treating advanced<unk> , the burns are used to destroy the abnormal new blood vessels that form in the retina. This has been shown to reduce the risk of severe vision loss for eyes at risk by 50%. Before using the laser, the ophthalmologist dilates the pupil and applies anaesthetic<unk> ops to numb the eye. In some cases, the doctor also may numb the area behind the eye to reduce discomfort. The patient sits facing the laser machine while the doctor holds a special lens on the eye. The physician can use a single spot laser, a pattern scan laser for two dimensional patterns such as squares, rings and arcs, or a navigated laser which works by tracking retinal eye movements in real time. During the procedure, the patient will see flashes of light. These flashes often create an uncomfortable stinging sensation for the patient. After the laser treatment, patients should be advised not to<unk> ive for a few hours while the pupils are still dilated. Vision will most likely remain blurry for the rest of the day. Though there should not be much pain in the eye itself, an ice-cream headache like pain may last for hours afterwards. Patients will lose some of their peripheral vision after this surgery although it may be barely noticeable by the patient. The procedure does however save the center of the patient's sight. Laser surgery may also slightly reduce colour and night vision. A person with proliferative retinopathy will always be at risk for new bleeding, as well as glaucoma, a complication from the new blood vessels. This means that multiple treatments may be required to protect vision. Medications Intravitreal triamcinolone acetonide Triamcinolone is a long acting steroid preparation. Treating people with DME with intravitreal injections of triamcinolone may lead to a some degree of improvement in visual acuity when compared to eyes treated with placebo injections. When injected in the vitreous cavity, the steroid decreases the macular edema (thickening of the retina at the macula) caused due to<unk>  maculopathy, and that may result in an increase in visual acuity. The effect of triamcinolone is not permnanent and may last up to three months, which necessitates repeated injections for maintaining the beneficial effect. Best results of intravitreal Triamcinolone have been found in eyes that have already undergone cataract surgery. Complications of intravitreal injection of triamcinolone may include cataract, steroid-induced glaucoma, and endophthalmitis. Intravitreal anti-VEGF There are good results from multiple doses of intravitreal injections of anti-VEGF<unk> ugs such as bevacizumab. A 2017 systematic review update found moderate evidence that aflibercept may have advantages in improving visual outcomes over bevacizumab and ranibizumab, after one year. In cases with vitreous hemorrhage, however, anti-VEGF injections proved to be less effective in restoring visual acuity than vitrectomy combined with panretinal laser-photocoagulation. Present recommended treatment for<unk>  macular edema is multiple injections of anti-VEGF<unk> ugs sometimes combined with Modified Grid laser photocoagulation. Sustained delivery systems for anti-VEGF medications can reduce the chances of endophthalmitis development by reducing the number of intravitreal injections necessary for treatment. Hydrogels have shown great promise for this platform. Topical medications There is little evidence for the role of topical medications in the treatment of macular edema, for example, topical non‐steroidal anti‐inflammatory agents. Surgery Instead of laser surgery, some people require a vitrectomy to restore vision. A vitrectomy is performed when there is a lot of blood in the vitreous. It involves removing the cloudy vitreous and replacing it with a saline solution. Studies show that people who have a vitrectomy soon after a large hemorrhage are more likely to protect their vision than someone who waits to have the operation. Early vitrectomy is especially effective in people with insulin-dependent diabetes, who may be at greater risk of blindness from a hemorrhage into the eye. Vitrectomy may be done under general or local anesthesia. The doctor makes a tiny incision in the sclera, or white of the eye. Next, a small instrument is placed into the eye to remove the vitreous and insert the saline solution into the eye. Patients may be able to return home soon after the vitrectomy, or may be asked to stay in the hospital overnight. After the operation, the eye will be red and sensitive, and patients usually need to wear an eyepatch for a few days or weeks to protect the eye. Medicated eye<unk> ops are also prescribed to protect against infection. There is evidence which suggests anti-VEGF<unk> ugs given either prior to or during vitrectomy may reduce the risk of posterior vitreous cavity haemorrhage. Vitrectomy is frequently combined with other modalities of treatment.
Diabetic retinopathy
Autoimmune retinopathy
Hypertensive retinopathy
Radiation retinopathy
Photic retinopathy
Retinal vasculitis
Autoimmune optic neuropathy
Sickle cell retinopathy