Diabetes is a major concern throughout the world. The prevalence of diabetes as well as the number of the diabetic retinopathy are relentlessly increasing. Diabetic Macular Oedema (DMO) is one of the commonest cause of visual loss in recent years. In today's topic we'll be discussing about treatment of diabetic retinopaty in a concise form.

1. TREATMENT OF
DIABETIC RETINOPATHY
By Dr. Golam Mortuza

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:VA≤6/15:-
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 500μ
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