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TREATMENT OF
DIABETIC RETINOPATHY
By Dr. Golam Mortuza
Management of Diabetes
Drugs for DM:
 Oral hypoglycaemic
drugs
 Insulin injections
Other cares:
 Diet and Exercise
 Risk reduction: Rx of
Hypertension and
Hyperlipidemia
 R/O Anaemia and Renal
failure
 Quit smoking and
tobacco in any form
Centre involved
DMO or CSMO:
Phakic Eye Pseudophakic eye Anti-VEGF
Contraindicated
(Pregnancy, Recent MI)
Intravitreal Anti-
VEGF:VA6/15:-
Aflibercept VA>6/15:-
Aflibercept,Ranibizumab
or Bevacizumab
Intravitreal Triamcenolone Intravitreal Triamcenolone
Note:
 Intravitreal Triamcenolone might cause cataract in phakic eye.
 Laser or Intravitreal Triamcenolone may be tried after 6 injections of Anti-
VEGF (given monthly) if these fail to reduce CSMO
Off Centre DMO
(outside 500亮
from foveola):
Focal or Grid laser
Note:
 Intravitreal Anti-VEGF or Triamcinolone may be tried
if it fails to reduce oedema
DMO with PDR:
Inj Ranibizumab or
Aflibercept followed
by PRP.
Note:
PRP is done in 2-3
sittings to get rid of
exerbation of macular
oedema.
PDR without
DMO:
PRP in 2-3 sittings
Note:
Alternatively Inj
Ranibizumab or
Aflibercept may be
given. Inj
Bevacizumab is not
that effective.
Indications of
Surgery in
Diabetic
Retinopaty:
 Resistant cases,
particularly if VMT
or ERM is present
ADED

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Treatment of Diabetic Retinopathy.pptx

  • 2. Management of Diabetes Drugs for DM: Oral hypoglycaemic drugs Insulin injections Other cares: Diet and Exercise Risk reduction: Rx of Hypertension and Hyperlipidemia R/O Anaemia and Renal failure Quit smoking and tobacco in any form
  • 3. Centre involved DMO or CSMO: Phakic Eye Pseudophakic eye Anti-VEGF Contraindicated (Pregnancy, Recent MI) Intravitreal Anti- VEGF:VA6/15:- Aflibercept VA>6/15:- Aflibercept,Ranibizumab or Bevacizumab Intravitreal Triamcenolone Intravitreal Triamcenolone Note: Intravitreal Triamcenolone might cause cataract in phakic eye. Laser or Intravitreal Triamcenolone may be tried after 6 injections of Anti- VEGF (given monthly) if these fail to reduce CSMO
  • 4. Off Centre DMO (outside 500亮 from foveola): Focal or Grid laser Note: Intravitreal Anti-VEGF or Triamcinolone may be tried if it fails to reduce oedema
  • 5. DMO with PDR: Inj Ranibizumab or Aflibercept followed by PRP. Note: PRP is done in 2-3 sittings to get rid of exerbation of macular oedema.
  • 6. PDR without DMO: PRP in 2-3 sittings Note: Alternatively Inj Ranibizumab or Aflibercept may be given. Inj Bevacizumab is not that effective.
  • 7. Indications of Surgery in Diabetic Retinopaty: Resistant cases, particularly if VMT or ERM is present ADED