Stage the retinopathy before choosing treatment
UKE distinguishes non-proliferative diabetic retinopathy, where abnormal new vessels are absent, from proliferative disease with neovascularization. Hemorrhage, vascular leakage, macular edema and later complications can occur at different stages. A treatment request should therefore include the retinopathy stage and whether DME is present rather than simply asking for 'diabetic eye surgery'.
Retinal examination, OCT and angiography answer different questions
Dilated retinal examination and photography document the overall retinal picture. OCT is central for macular edema and treatment follow-up. Fluorescein angiography can reveal vascular leakage, ischemic areas and abnormal vessels, while OCT angiography may add non-invasive vascular information in selected cases.
DME and proliferative retinopathy are related but not identical
DME is swelling at the macula and may reduce central vision even without advanced proliferative disease. Conversely, proliferative retinopathy can threaten vision through new vessels, hemorrhage and traction. The treatment sequence should therefore address the actual combination of macular edema, ischemia, neovascularization and traction in each eye.
Laser still has an important stage-specific role
UKE and University Hospital Cologne document retinal laser treatment for diabetic retinopathy. The target and extent depend on the retinal problem; panretinal treatment for proliferative disease is not the same as focal or adjunctive macular laser. The specialist should state what the laser is intended to treat and whether intravitreal therapy is also needed.
Vitrectomy is reserved for selected advanced complications
UKE describes vitrectomy for more severe diabetic retinal disease to remove vitreous hemorrhage and membranes and, when necessary, combine retinal coagulation with gas or silicone-oil tamponade. Surgery is therefore a complication-driven pathway rather than a routine treatment for every retinopathy grade.
Bring systemic and ophthalmic trend data
A German retina team can make a better decision when it sees both ocular progression and diabetes control over time.
- Latest retinal examination with retinopathy stage for each eye
- Macular OCT from both eyes
- Previous OCT for comparison
- Fundus photographs
- Fluorescein or OCT angiography if available
- Injection and laser history
- Any vitreous-hemorrhage or retinal-surgery reports
- Current visual acuity
- Recent HbA1c trend and diabetes medication
- Blood-pressure and kidney-disease history
- Antiplatelet or anticoagulant medication when relevant
New hemorrhage or abrupt visual change should not wait for medical travel
A sudden shower of dark floaters, marked new visual loss or a new field defect can indicate vitreous hemorrhage, retinal tear or detachment, or another urgent complication. These symptoms require prompt local ophthalmic assessment before elective international planning.
Official sources
Sources last checked 2026-09-13. Ophthalmic treatment can be time-sensitive, so confirm current recommendations directly with the treating eye team.
- Diabetic retinal disease – staging, diagnostics and treatment — University Medical Center Hamburg-Eppendorf (UKE) ↗
- Retinal diseases – diabetic retinopathy, OCT and anti-VEGF — University Medical Center Hamburg-Eppendorf (UKE) ↗
- Retinal surgery, laser treatment and intravitreal injections — University Hospital Cologne ↗
- Retinal diagnostics – OCT and angiography — University Hospital Cologne ↗
- Retinology – retinal imaging and diabetic retinopathy research — University Medical Center Freiburg ↗