Diabetic Retinopathy
In Diabetic Retinopathy there is leakage of blood, fluid and fat (lipid) from the retinal blood vessels. This causes the retina to swell and eventually deteriorate. Swelling that is close to the center of the retina, the macula, and has certain features is called "Clinically Significant Macular Edema" (CSME). When the swelling is very severe the retina breaks down and blisters or "cysts" of fluid form. This is called "Cystoid Macular Edema" (CME). CME results from long-standing or advanced macular edema. A fluorescein angiogram is a test performed to detect the leaks in the retinal circulation. In this test the patient receives special dye injected into a vein in the arm. The retina is photographed with a special light which causes the dye to "light up" the normal and abnormal blood vessels. This provides a road map to guide the surgeon to direct focal laser treatment at the leaking blood vessels in the macula. The laser light focally closes up the leaks, stopping the retinal swelling in the center of vision. Focal laser treatment helps to prevent loss of vision. In certain cases an injection of steroid into the eye is required to help treat retinal swelling. The purpose of focal laser and intraocular injections of steroids is to prevent further visual loss. Some patients do experience improvement of vision.