Therapeutic Injections for Diabetic Eye Disease
Triamcinolone acetonide is a type of corticosteroid that has been used for years to treat many diseases including eye disease, allergic reactions, arthritis, and skin diseases. This medication, which is administered as an intravitreal injection, can be successful in reducing swelling in the eye such as macular edema, associated with diabetic eye disease. More than one treatment may be required to treat your macular edema.
Our highly skilled retinal specialist performs these therapeutic injections in our clinic on an outpatient basis. Your eye will be numbed for the procedure, and the medication will be injected. Following the procedure, you may experience some mild discomfort in the eye. Most patients will also experience “floaters”, black spots floating across their vision for a couple of days. The most common side effects are blurry vision, redness, and sensitivity to light. Eye injections can also increase your eye pressure. However, the positive effects of reducing the swelling in the macula and preventing further vision loss more than outweigh the risks. There is a new treatment available, which is also a corticosteroid, called Ozurdex. This is a tiny implant, which gets injected into the vitreous. The medication is released over approximately a 4 month period of time. This is also done in the office setting, by your retina specialist. Ozurdex is not used on certain patients, such as those with Advanced Glaucoma.
Although infection rarely results from an eye injection, you should notify your doctor immediately if your symptoms should worsen rather than improve in the days following treatment. While floaters are normal for a few days following the treatment, if you experience flashes of light or a dark veil coming over the eye, this can be an indication of a detached retina. This requires immediate attention. Therefore, do not delay in contacting your doctor.
There are also other intravitreal injections used to treat diabetic retinopathy and macular edema. Injections of the drugs Lucentis, Avastin and Eylea are being used to treat wet age-related macular degeneration (AMD). These drugs inhibit blood vessels from growing under the retina. Such blood vessels are stimulated by a hormone called Vascular Endothelial Growth Factor (VEGF). These drugs are considered to be anti-VEGF agents.
In diabetic retinopathy, these blood vessels develop on top of the retina, rather than under it. Researchers believe that VEGF stimulates the growth of the blood vessels both on top of the retina, as well as increases leakage from the retinal capillaries. Clinical studies have shown that anti-VEGF agents such as Avastin and Lucentis, along with other VEGF blockers such as Eylea, are useful in treating diabetic retinopathy and macular edema.
Remember that once you’ve been diagnosed with diabetic eye disease, you may require dilated eye exams more than once a year. By keeping your blood sugar levels and blood pressure as close to normal as possible, and by keeping to the schedule of eye examination your doctor recommends, you’ll be doing your part to protect your vision.
