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Laser Treatment of Diabetic Retinopathy

Laser photocoagulation is a proven effective treatment for preserving vision and reducing the risk of vision loss from diabetic retinopathy. Pioneered by Drs. Lloyd M. Aiello and William P. Beetham in the late 1960s using a ruby laser, scatter (or panretinal) laser photocoagulation reduces the risk of severe vision loss by 60% or more. In national clinical trials of laser treatment for diabetic retinopathy conducted at multiple locations, laser photocoagulation reduced the risk of severe vision loss from diabetic retinopathy to less than 2% over a five-year period. More than 3,700 patients participated in this Early Treatment Diabetic Retinopathy Study, which was chaired by Dr. Lloyd M. Aiello. The Beetham Eye Institute was the largest clinical center in this study, enrolling more than 250 patients. This study also showed that focal laser photocoagulation reduces the risk of vision loss from macular edema by 50% or more.

Two laser techniques are performed today, generally using an argon laser:

--Scatter or panretinal photocoagulation generally requires 1,200-1,800 individual laser spots, usually spread over two or three sessions. In this technique the ophthalmologist avoids the macula, the central area of the retina that is responsible for our reading vision, color vision, and other tasks requiring sharp vision. Scatter laser photocoagulation is used to treat proliferative diabetic retinopathy, a major cause of severe vision loss from diabetes.

--Focal laser surgery uses fewer spots and less intense laser power to treat diabetic macular edema. Using a technique called fluorescein angiography and other examination and photographic techniques, the ophthalmologist identifies areas that are leaking fluid into the macula area. These areas are then treated directly with a laser to prevent further leakage of fluid into the macula and to allow fluid that has already leaked to be reabsorbed.

Blood glucose control and management of other medical issues such as cholesterol levels, blood pressure, and kidney disease are also important in reducing the risk of diabetic retinopathy. Treatments for diabetic retinopathy other than laser photocoagulation are currently under investigation. Until a method to prevent or cure retinopathy is discovered, the best way to preserve vision is to have regular eye examinations and to maintain good control of blood glucose levels, blood pressure, and other medical conditions.

The Beetham Eye Institute is located at the Joslin Diabetes Center. The Beetham is dedicated to providing total eye care services that prevent, diagnose, and treat eye problems related to diabetes. For more information about The Beetham Eye Institute, please click here.

Page last updated: October 23, 2014