Retinopathy and intravitee injections

Hello everyone,

I am new, I have gone to the ophthalmológo and although I still have no vision problems, I have seen some small exudates and wants to wear intravitreal injections ...

Has anyone put them on? Are they painful? How do they work?

Thank you!

Well, we don't know how to answer you..

But if you have confidence that he is a good doctor, he will make you a good treatment.Retinopathy can now be treated very early and with good results.

Hi @Joselu48, I wouldn't know how to tell you, however, I would like you to explain how the treatment has gone and how it has been!;)

There are three injections in each eye, on Friday I put the second in the left I will tell you.Thank you

regina said:
but if you have confidence that he is a good doctor, he will put a good treatment.Retinopathy can now be treated very early and with good results.

I expect thanks

I had not heard it, but I am also interested in the subject ... you tell us :)

Hi @Joselu48.In Casa Alberto deposed intravitee injections by macular degeneration.As they say they do not hurt, if it is true that they are annoying and that the eye sees.They also usually put a few anesthesia drops.As my boy told me, the feeling is like the prick of insulin that does not hurt, sometimes they do not hurt, that you notice that something enters and notice the entrance of the liquid, but pain does not.

I don't know if it uses you something.

Hello, I am sorry I had not read this comment before.It seems to me that the case is not completely studied.Retinal exudates respond to different causes.There are hard exudates that are composed of lipids and that are accumulated that are deposited in the retina and that come from a micro -vascular alteration that is consubstantial to long -evolving diabetics, and that derive in an extravasation of blood and other intravascular products.
There are other exudates called cottons, because of their appearance, and that are a consequence of small infarctions of one of the retinal layers.These translate much greater gravity, as they indicate a more serious vascular state and are predictive of greater complications.To know what is happening in a retina, it is necessary to make angiofluoresceingraphy (AFG), which consists of intravenously injecting a dye, fluorescein, and that will dye a series of alterations that are not visible to the naked eye.Once this test is done, we can get an exact idea of ​​what is happening and the treatment to be used.Classically, Argon laser photocoagulation has been used, treating the pathological areas of the retina to prevent it from evolving to final and very serious stages, of the disease.
For a few years (more than 10), retinal pathologies are being treated with anti -EGF injections (acronym in English of endothelial vascular growth factor), which is a product detected in the diabetic retina and other vascular patients and that is supposed to be, they are the ones that lead to the most advanced phases of retinopathy and of course, of blindness.The problem is that, the intravitreous injections of antivegf by the way, not painful, is a symptomatic treatment, that is, it does not prevent the problem from continuing (VEGF will continue to appear), so it would be a treatment to be used duringlifetime.
Of course I recommend, to make a deep exploration, and whenever you can resort to laser photocoagulation, it is much better because the retinal problem completely interrupts, where the treatment is implanted

@Oftalmologo, with all your years of diabetic CPN experience, have you observed any improvement in retinopathy with glycosilated control?

Have you advanced anything with retinopathy? Is there any cure? ...

No, retinal lesions caused by diabetes are irreversible.I do not want to be alarmist, but I will try to explain the process because you have to know your problem because it is the best way to fight it.
The body can withstand a certain amount of blood sugar.If the mechanisms responsible for neutralizing or metabolizing it, are altered, there is an excessive blood sugar accumulation and this excess produces lesions in blood vessels, especially in small arteries and veins, in an eye, kidney and brain, not only there,But especially there.Once the lesions in the vessels have occurred, a pathological process that culminates in the establishment of diabetic retinopathy (RD), or nephropathy or neuropathy begins.
Obviously, the normalization of glucose figures is a very positive fact, which will prevent injuries from continuing, but will not be able to repair those that have already occurred.We could compare the process to which a irrigation system would occur in which a certain amount of acid was injected.Depending on that amount, and the concentration reached in circulating water, more or less serious damage will occur on the wall of the pipes.Logically, if we stop introducing acid, we will not continue to damage the walls but we will not repair the damage.Let's say, saving distances, that excess glucose behaves similarly.
You put things like this, we will perfectly understand that the RD is not reversible, and in a way, inevitable, but these are the bad news.Let's look at the good:
Since the RD begins, until severe stages are reached that affect the vision, many years pass, so that, as soon as we diagnose the problem, before we can put the means that abort the process, by meansThat is necessary to diagnose the disease very early, and that is only possible by angiography with fluorescein.Once diagnosed and guided by hemoglobin control, it will be very difficult for the disease (RD) to go ahead of us and surprise us.In early and intermediate stages of the disease, medications administered through intravitreous injections, they make sense.These medications are used to treat serious macular edema (which are not susceptible to laser treatment) and the best treatment for macular edema is that it does not occur.
The better the glycosylated hemoglobin figure, the more the signs of RD are presented and more slowly progress.In this regard, I think it is necessary to clarify that glycosilated hemoglobin is an analysis that reveals the average blood glucose figure of the 3 months prior to the test, and ciñé to the regina's question, a figure of 6.5, is aGood figure, which will maintain the problem in not too serious stages and its evolution will be very slow, but will evolve.
Finally, and in response to Roar, medicines have been discovered that allow to treat (without much success by the way) very serious injuries that have seriously affected the vision, and that were previously intractable, but today, the best treatment is to preventthat very serious phases of the RD and laser treatment are reached as early as possible.
I guess more questions will arise and many points will have to be clarified.I will do it to the extent of my possibilities.

Thank you very much for your explanation and help,@ophthalmologist.
We have to expect that treatments continue to improve in every way.
A hug.

How good to have you among us, @Oftalmologo!It is a privilege to have your explanations and your professional opinion.Thank you very much for being part of this superequipo that we make between everyone.I also have a question ... Lei has long since been a certain degree of myopia, high mypia, protiating in a way in front of diabetic retinopathy.Is this correct?

Yes, the RD has a lower prevalence among great myopes, which have a high degree of retinal atrophy.Of course, if there is no retina to affect, of course, the condition is less, but it is a sad comfort.It is something like that the poor do not affect the cracks of world bags too much, or that they cannot be killed in a Ferrari.
I am delighted to collaborate with you.After so much time to live with diabetics, I have empathized a lot with your problem.Something like being diabetic without having to put insulin, because when as some sweet, I feel, in a way, guilty

We eat sweets, huh?With fast insulin you can :))

They gave me the laser a long time ago and then I have put the intravitreal injections and very good.They put me more.Thanks I had not seen the comments.All the best

Oh, @Joselu48!Greetings, by the way.But that Yuyu gives me everything that is to touch my eyes.I just listened to the injections here and I already have nightmares for the remains.

In my case, I am official since September 2015 and I am in laser treatment.Doctors say it is something strange that, being so recent and with such a relatively good view, has a quite bad eye background.I am a little crowded at times and I have a couple of questions for which you know how to answer:

1) It is clear that your view, when you lose it, you will not recover it.Now, will we end up blind yes or yes?And is linking with the second.

2) Controlling your diabetes, you reduce the progress of the disease, along with timely medical treatment.Ok But are hyper more serious than the hypos for the eyes?Does no matter?

3) Does insulin have a negative effect on our body?For our oios?

Anyway, many moods, especially and everyone in general!

I understand that you are a diabetic (probably type 2 of recent diagnosis so your doctors are surprised that you have an advanced RD, although with good vision. We have already explained this in previous comments:
1.- It is perfectly possible to have a serious RD picture retaining a normal vision, since the macula is not or is minimally.Obviously, you have to try through laser treatment and, where appropriate, with intravitreous injections, conserve the vision you keep in all or part (quiet, the injections are practically painless).And above all things you have to get strict sugar control, so as not to continue worsening
2.- That you have an advanced RD with a recent illness, it is not strange as your doctors say, it is impossible.You can make sure you have been diabetic for many years without knowing it, and therefore, without treating you.In international literature, it is ensured that it is impossible, and no Case of RD has been described in patients with less than 5 years of evolution of the disease, nor in prepubertal stages, even if it is diabetic from the moment of birth.That is why I understand that you should be of type2 since the diagnosis in type1 is quite accurate, and in type 2, the disease can remain a long time, subclinical.In fact, there are enough cases in which the disease is diagnosed through a background exploration.Even when an RD is perceived in the background, we can already assume that the eye is affected long before and has only become visible.It is the same phenomenon as that of the icebergs.
3.- Obviously, and as I explained above, blood vessels deteriorate in hyperglycemia situations, so hyper are more serious than hypos
4.- No, insulin is not harmful to the eyes, although if there have been cases in which the abrupt regulation of decompensated diabetes for years, it could be harmful to pre-existing retinopathy.It is considered more appropriate, the gradual metabolic regulation.
I hope I have clarified your doubts.Good luck

Thank you very much, @Oftalmologo.You have helped me a lot.

I am of type 1, although from the beginning the doctors have always had certain doubts precisely because of how relatively strange my case is.

:) To follow the fight!