Episode #15- Proliferative Diabetic Retinopathy — Understanding the Complexity Beyond Retinal Bleeding

Ayurveda and Eye Treatment is a podcast on the specialty of Eye treatment in Ayurveda. The podcast aims to give insights about treatment of eye diseases in Ayurveda. In this episode, Dr. P.K. Santhakumari, Chief Physician at Matha Ayurveda Eye Hospital, explains about "Proliferative Diabetic Retinopathy"(PDR), is one of the advanced stages of diabetic retinal disease. Diabetic Retinopathy itself is broadly divided into two major stages :— Non-Proliferative Diabetic Retinopathy Proliferative Diabetic RetinopathyPDR is considered more complex because of the extensive pathological changes occurring within the retinal blood vessels.The primary changes in PDR occur in the retinal vasculature. Due to long-standing diabetes and vascular damage, the retinal blood vessels become weak and unhealthy, leading to leakage, hemorrhage and impaired circulation inside the retina. As circulation becomes compromised, retinal hypoxia develops, meaning the retinal tissue does not receive adequate oxygen supply.To compensate for this reduced oxygen, the body attempts to create collateral or newly formed vessels. However, these vessels are often delicate and structurally unhealthy. In many patients, these abnormal vessels form extensive vascular networks over the retinal surface and may even extend into the vitreous chamber.This stage becomes particularly challenging because these fragile vessels can bleed repeatedly and create further complications. Management itself may become difficult because the abnormal vascular network may adhere to the vitreous gel. During procedures aimed at removing these changes, the vitreous gel may also need to be removed, increasing the complexity of management. In some patients, vitreous detachment and other retinal complications may also occur.Because the pathological changes differ from patient to patient, treatment planning also varies significantly. Proper differential diagnosis and stage assessment become extremely important before deciding management. Understanding whether the predominant issue is hemorrhage, ischemia, vascular proliferation, tractional changes or detachment helps determine the direction of treatment.In Ayurveda, assessment of Dosha predominance is considered essential in Proliferative Diabetic Retinopathy. In many cases, Pitta dominance is seen prominently because of its relationship with Raktha Dhatu, vascular instability, bleeding tendencies and inflammatory changes. Therefore, one of the important principles of management is Shamana of Pitta and regulation of its aggravated properties.Treatment is not generalized. The selection of medicines and therapies changes according to the stage of disease, the retinal findings, the extent of hemorrhage and associated complications. In conditions where hemorrhage and vascular irritation are prominent, therapies such as Shirodhara, Netra Sekam and Bidalaka may be considered as part of the management plan.Therapies like Anjanam, carefully selected ocular applications, Nasya and internal medicines may be used differently depending on the clinical condition and Dosha involvement. In more complex situations involving retinal traction or detachment related changes, treatments such as Shirolepanam, Bidalakam and selected forms of Tharpanam may also be considered. Medicine selection remains highly individualized because retinal conditions at this stage are delicate and require careful judgment.At Matha Ayurveda Eye Hospital, retinal vascular conditions such as Proliferative Diabetic Retinopathy are approached through detailed clinical assessment, individualized treatment planning, structured inpatient care whenever required and continuous monitoring. The emphasis is on understanding the stage of disease, maintaining retinal stability, and supporting long-term ocular health through a systematic Ayurvedic approach.visit:For appointments call- +91 9847195533Website: https://zurl.co/G4xQmEmail: [email protected]