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It is important to remember that no two patients with Diabetic Retinopathy are the same and that Diabetic Retinopathy changes with time in every patient. Therefore, treatment must be continually reevaluated and individualized to the situation at hand.

Your NRI retina specialist is uniquely qualified to develop a follow-up treatment regimen that is individualized to suit how diabetes is affecting your eye.

What is Diabetic Retinopathy?

Diabetes causes changes in retinal blood vessels
Diabetes damages the circulatory system of the retina. Capillaries, the tiny blood vessels that supply the retina, weaken and begin to leak fluid. This can cause two major medical problems: diabetic macular edema, or retinal swelling; and retinal neovascularization, or the growth of new, abnormal blood vessels.

Diabetic Macular Edema (DME) is the leading cause of permanent vision loss among diabetics. Retinal swelling resulting from DME causes a slow but progressive blurring of vision with severe irreversible vision loss as the end result. It is possible to see the early signs of DME before the vision has started to blur, which is one of the reasons that it’s important for all people with diabetes to have regular detailed retinal exams and advanced diagnostic testing. Beginning treatment prior to vision loss is the best way to reduce the risk of blindness.

Retinal Neovascularization occurs when weakened blood vessels get progressively narrower and eventually close. This causes the growth of abnormal new blood vessels. These blood vessels are extremely fragile, and tend to break easily, causing hemorrhage. If left untreated, these hemorrhages and blood vessels can cause scarring, often leading to severe retinal detachment causing profound vision loss. As with DME, it is possible to have early signs of neovascularization without any loss of vision, and early treatment is recommended to maintain good vision.

The NRI Advanced Approach to Diagnosis and Treatment

How the unique cutting-edge technology and expertise at NRI can help you.
Physicians at NRI continue to develop and search the world for the most advanced battery of diagnostic and treatment tools so that they can individualize treatment for you. Our philosophy is simple; we are here to use every possible tool to prevent Diabetic Retinopathy from stealing your vision.

In order to detect DME and retinal neovascularization at their earliest stages so that treatment can be applied in the most effective manner, NRI doctors use the most advanced and comprehensive group of diagnostic tests available.

Confocal Scanning Laser Fluorescein Angiography
This is a highly advanced computerized system that provides far more sensitivity than systems found at most other centers. It allows the most precise determination of retinal blood vessel leakage, ischemia, and neovascularization currently available.

High Definition Ocular Computerized Tomography
This is the latest technology that allows us to use light to create a microscopic view of the actual cells in the retina being affected during the process of retinal swelling or edema.

Vitreous Proteomics
This novel technology developed at NRI now allows our doctors to determine which biochemical responses are active at any stage in the diabetic retinopathy process, thereby greatly enhancing the potential to use the optimal treatment for you.

NRI Cutting-edge Treatments
Based upon the comprehensive testing previously outlined, your NRI doctor will design an individualized treatment regimen for you. Also, using these techniques, your doctor will modify the treatment to continually optimize your response. The following are among the cutting-edge treatments available.

Focal Laser Guided by the Confocal Scanning Laser Fluorescein Angiography and

High Definition Ocular Computerized Tomography, Focal Laser is applied to leakage near the macula to cause swelling to regress.

Pan-Retinal Photocoagulation (PRP) Guided by Confocal Scanning Laser Fluorescein Angiography, laser is applied to areas of retinal blood vessel abnormalities. As a result, the neovascularization will often shrink.

Anti-Inflammatory Steroid Injections These injections are often used at NRI in combination with other treatments when the Vitreous Proteome indicates significant inflammatory activity.

Anti-VEGF Injections Current drugs available are Avastin, Lucentis, and Macugen with more on the way. We are currently developing new ways to determine which of these drugs might be best for each individual patient.

Non-Steroidal Anti-Inflammatory Drugs These drugs are being evaluated at NRI for some specific inflammatory activity detected in the Vitreous Proteome of certain patients.

New Treatments on the Horizon Physicians and researchers at NRI are participating in the development of new treatments. With the use of our advanced diagnostics, these treatments will also be used to expand the individualization of treatment for our patients.

NRI doctors have developed protocols to combine these treatments to maximize their effectiveness.

What Can You Do to Reduce Your Risk of Vision Loss from Diabetic Retinopathy?

• Control Blood Sugars and Hemoglobin A1c
• Regular Exams by Retina Specialists Using Advanced Diagnostic Testing Before Loss of Vision