Diabetic Retinopathy Treatment: Laser Photocoagulation, Anti-VEGF, and Strict Glycemic Control

Diabetic retinopathy is one of the most common microvascular complications of diabetes mellitus and a leading cause of blindness in working-age adults. The treatment of this condition has evolved significantly, integrating both ophthalmological interventions and strict glycemic control to prevent its progression. In this context, laser photocoagulation and metabolic management are fundamental pillars in the therapeutic approach.

Diving Deeper into Treatment

Panretinal photocoagulation has long been the standard treatment for proliferative diabetic retinopathy. This procedure uses a laser to create small burns on the retina, helping to reduce the growth of new abnormal blood vessels and prevent hemorrhages. While effective, it may have side effects such as loss of peripheral and night vision. Nevertheless, it remains a crucial tool in managing the disease, especially in advanced stages [1].

In addition to photocoagulation, the use of anti-VEGF agents has revolutionized the treatment of diabetic retinopathy, particularly in diabetic macular edema. These medications, administered via intravitreal injections, inhibit vascular endothelial growth factor, thereby reducing vascular permeability and edema [2]. However, their repeated administration can be uncomfortable and costly, underscoring the importance of a comprehensive approach that includes metabolic control [3].

Strict glycemic control is essential to prevent the progression of diabetic retinopathy. Studies have shown that intensive glucose control, along with management of blood pressure and lipids, can significantly reduce the risk of disease progression [4]. Vitrectomy is another surgical option for severe cases, especially when there is persistent vitreous hemorrhage or retinal detachment [5].

Conclusions

The treatment of diabetic retinopathy requires a multifaceted approach that combines laser photocoagulation, the use of anti-VEGF, and strict glycemic control. The integration of these strategies not only improves visual outcomes but also reduces the long-term burden of the disease. Ongoing research and the development of new therapies, such as neuroprotection and anti-inflammatory treatments, promise to further enhance the management of this complex disease [6].

References

• [1] Diabetic retinopathy: current and new treatment options
• [2] Diabetic Retinopathy: An Overview of Treatments
• [3] Oxidative Stress and Microvascular Alterations in Diabetic Retinopathy: Future Therapies
• [4] Effects of medical therapies on retinopathy progression in type 2 diabetes
• [5] Updates on the Current Treatments for Diabetic Retinopathy and Possibility of Future Oral Therapy
• [6] New Insights into Treating Early and Advanced Stage Diabetic Retinopathy

Created 6/1/2025