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The Question
03/30/09 03:35 PM

"What is considered the gold standard for treating moderate NPDR and macular edema? I am concerned about the options I have been given."
Asked By: gbnaz1  
Category: Vision

Background Info Hide
I was unexpectedly diagnosed with diabetes as well as pnuemonia in December 2007. At the hospital the actually glucose level was 894. They diagnosed me as Type1. I was put on long acting as well as short acting insulin. I left the hospital on my fifth day. Before being diagnosed I needed glasses for distance, while still in the hospital my vision seemed clearer and I found I did not need my distance glasses at all. I went to see an opthamologist at the end of April 2008. He gave me a new presrciption ( a weaker one) and I could see really well. He also diagnosed me with moderate NDPR and said I might need laser treatment in the next several years and in August of 2008 I had an alarming episode in both eyes on the same day, same time that was diagnosed as floaters. In January of 2009 I was diagnosed with Macular Edema in one eye. I went to see a retina specialist and he wanted to treat me with laser and Avastin. I'm considering a supplement, pine bark.

Expert Answers (1)

09/02/09 07:49 PM

Dear GbNaz1: Preventions for eyes free of disease.Optimize blood sugar management would be the gold standard. Early detection is the key to prevent retinopathy. Control of blood glucose (<140mg/dl at all times-if possible), blood pressure (<130/80mgHG) and lipids (<100LDL, HDL>50 for women and >40 for men), Tgs<150mg/dl, if you smoke stop, are essential prevention techniques. The A1C(<7%) is considered the "Gold Standard" for evaluation of diabetes control .Screening for the presence of potential complications consists of:
  • a dilated and comprehensive eye examination by an ophthalmologist which would include
  • the dilated indirect ophthalmoscopy with biomicroscopy and
  • 7-standard field stereoscopic 30-degree fundus photography. The first step toward preventing or delaying the onset of diabetic retinopathy is to achieve and maintain tight glycemic control. Both the ADA and American Association of Clinical Endocrinologists guidelines advocate the same recommendations in this regard. Moderate non-proliferative diabetic retinopathy (NPDR) and macular edema are considered eye diseases which are a complication of the diagnosis of diabetes mellitus. The tiny micro vascular blood vessels of this area are especially susceptible to development of complications. Of the 3 main eye diseases :
  • retinopathy,
  • cataracts and
  • glaucoma,
  • retinopathy is one of the most common. The retina is the lining at the back of the eye that senses light. These small blood vessels in the retina can develop blockages of impulses identified as retinopathy, proliferative or nonproliferative. The hallmark signs of NPDR are the bulging and pouches that occur. Worsening of the disease will result in larger amounts of fluid, resulting in swelling which can impact your sight. The center of the retina is the macula. The macula lets you see fine details. Swelling in this area is identified as macular edema. Macular edema can blur, distort, reduce or darken your sight. Sue
    • Answered By: Susan Throop
    Accreditations: RD, CDE, MA
    Sources Show

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