Diabetic macular edema (DME) is a complication of diabetic retinopathy, a diabetic eye disease. According to the National Eye Institute, DME affects an estimated 750,000 people in the United States, and it is the leading cause of blindness in diabetic retinopathy patients. DME has no cure, but treatment can halt or slow its progression. Continue …
Diabetic macular edema (DME) is a complication of diabetic retinopathy, a diabetic eye disease. According to the National Eye Institute, DME affects an estimated 750,000 people in the United States, and it is the leading cause of blindness in diabetic retinopathy patients. DME has no cure, but treatment can halt or slow its progression. Continue reading to learn more about DME, treatment options and goals, and how you can protect your vision.
What exactly is diabetic macular edema?
DME is a diabetic retinopathy complication that can result in vision loss and blindness.
Diabetic retinopathy is a common eye disease caused by diabetes. According to the National Institute of Diabetes and Digestive and Kidney Diseases, it affects roughly one in every three diabetics over 40 years old.
Diabetic retinopathy develops when your blood sugar levels are consistently high, causing damage to the small blood vessels throughout your body, including your eyes.
When blood vessels are damaged, they can begin to leak blood and other fluids. The retina, a part of your eye, can absorb some of the excess liquid. When there is too much fluid, the macula, an area in the center of the retina that helps you see clearly and precisely, can swell and thicken.
At first, you may not notice any signs of DME. However, DME can cause symptoms such as:
- Blind spots and floaters
- Double vision
- Loss of vision, partial or total
- Faded and less vibrant colours
- A sight that is blurry or wavy near the center of your field of vision
The longer you have diabetes, the more likely you will develop diabetic retinopathy, also known as DME.
Is diabetic macular edema curable?
There is no cure for DME, but scientists are investigating potential ways to reverse or prevent the condition’s vision damage.
According to the National Eye Institute, researchers are investigating whether micro-RNAs or molecules that regulate specific genes can aid in the shutting down of genes associated with the development of macular edema. More research is required.
Meanwhile, macular degeneration treatments and diabetes management strategies can help to halt or slow the disease’s progression.
The macular edema treatment’s goal is to prevent further vision loss or blindness. In some cases, treatment can improve vision in people with DME but rarely fully restores sight.
Options for treatment
If DME hasn’t made a noticeable difference in your vision, you may not require immediate treatment.
However, your eye doctor will want to notice signs that the condition is worsening, so you may need to get regular vision checks.
Doctors usually initiate treatment once your vision deteriorates to avoid permanent damage.
The severity of your vision loss determines your DME treatment options. An ophthalmologist may recommend a combination of therapies at times.
Here are some DME treatment options:
Anti-VEGF treatment
These injections inhibit the activity of vascular endothelial growth factor (VEGF), which promotes blood vessel growth. It can slow the progression of DME by reducing leakage from damaged blood vessels.
Anti-VEGF medications include:
- bevacizumab (Avastin)
- ranibizumab (Lucentis)
- aflibercept (Eylea)
Anti-VEGF therapy is typically a quick procedure performed in the doctor’s office. You will not be able to feel the needle if you use numbing drops. To keep your vision, you may need a series of anti-VEGF injections over time.
Anti-VEGF injections, unfortunately, do not work for everyone. According to the National Eye Institute, roughly half of those who try this treatment do not see any improvement.
Laser therapy
Laser therapy seals off leaky blood vessels by using tiny laser pulses. It can also prevent the formation of new abnormal blood vessels.
You can do laser therapy in a doctor’s office. It is a painless procedure, thanks to anesthetic eye drops. A doctor will use special instruments to keep your eye open and your head from moving while focusing the light beam on the damaged areas.
If you have macular edema in both eyes, your doctor will most likely treat it separately. Depending on the extent of the macula damage, you may require several laser therapy appointments.
Laser therapy can reduce the risk of vision loss caused by DME.
It’s worth noting that, while laser therapy was once the standard treatment for DME, most doctors now rely on anti-VEGF injections instead.
Anti-inflammatory medications
Corticosteroids can also aid in the treatment of DME by decreasing inflammation and swelling. They are administered as drops, tablets, or injections into or around the eye.
In addition, doctors have approved three sustained-release corticosteroid implants for the treatment of DME:
- fluocinolone (Retisert)
- fluocinolone acetonide (Iluvien)
- dexamethasone (Ozurdex)
When corticosteroids fail to work or are not well tolerated, your doctor may advise you to try nonsteroidal anti-inflammatory drug eye drops (NSAIDs).
Surgery
Surgery may be an option in advanced cases of DME. It entails a vitrectomy to remove vitreous, a gel-like substance that fills the inside of the eye and can pull on the macula.
After removing the vitreous, the surgeon will replace it with another substance, such as a saline solution.
Remember that vitrectomy may increase your risk of cataracts, and you may develop DME again after surgery.
Other methods for slowing or reversing the progression of diabetic macular edema
Understanding the risk factors for DME can help you take preventative measures. These are some examples:
- high-fat levels in the blood (hyperlipidemia)
- blood pressure is too high
- high blood sugar levels for an extended period
Keeping an eye on these conditions and managing your diabetes can help you improve your symptoms and your eye health. Other diabetes-management strategies include:
- participate in regular physical activity
- consume a nutritious, well-balanced diet
- give up smoking
- inform your doctor about any new or worsening symptoms
- every year, get a thorough eye examination
- take medications as directed
- consult your endocrinologist as directed
- avoid or reduce your alcohol consumption
- maintain a healthy weight for your body type and size, as advised by your doctor or healthcare provider
Diabetic Macular Edema is a diabetic retinopathy complication caused by long-term damage to blood vessels in the retina. Although there is no cure, you can manage DME. There are several treatments available to help slow the progression of the disease and prevent partial or total vision loss.
Scientists are investigating the possibility of using micro-RNAs to treat or prevent DME, but more research is needed. If you notice symptoms of DME, such as blurry or wavy vision or colours that appear less vibrant than usual, consult an eye care professional immediately.
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