New Hope for Those at Risk for Blindness Due to Diabetes

Doctors Steven Bloom and Inder Singal , both vitreoretinal specialists at Bennett & Bloom Eye Centers, are very excited about this new treatment. "We are now often able to not only prevent vision loss but also often make patients see dramatically better," says Dr. Singal. "Patients often return for their 1-week post-operative visit with the edema resolved and vision dramatically improved."

Macular edema occurs when the retina's blood vessels sprout tiny leaks, making the retina swell and not work properly. When this happens the central vision can become blurred. Some patients will fail to respond to traditional laser photocoagulation.  For many of these individuals, injection of anti-inflammatory steroid medication into the eye appears to rapidly improve macular edema and vision loss. Corticosteroids have been used successfully in the treatment of macular edema due to their ability to make the retinal vessels less "leaky."

Triamcinolone is currently the preferred corticosteroid because it is readily available, inexpensive, and has an effective duration of action of up to 4-6 months. Intravitreous injection delivers the medication directly to the site of action-the vitreous, a transparent jellylike substance behind the lens of the eye. The painless injections are performed in the office. Potential side effects include elevated intraocular pressure (mostly controllable with topical medication), cataract, and a less than 1% risk of endophthalmitis (an inflammation of the internal structures of the eye). Patients often need multiple injections since the edema usually recurs after four to six months.

"Regular dilated eye exams can catch diseases such as diabetic retinopathy early and allow us to prevent or treat vision loss," said Dr. Singal. "With new treatments, such as triamcinolone injections being discovered, it gives diabetic patients even more reason to be hopeful about the future of their vision."