Definition & Overview
Diabetic macular edema (DME) is a leading cause of blindness in people with diabetes. It occurs when fluid builds up in the macula. The macula is part of the eye’s retina. It provides the ability to see objects in detail.
DME is a complication of diabetic retinopathy. It is a serious condition that can lead to vision impairment and even blindness. As such, it is important that it is diagnosed and treated in its early stages. Early treatment can prevent it from progressing.
Modern treatment methods for the condition include the use of lasers. Lasers can seal off leaking blood vessels. This stops fluid from leaking into the macula. Treatment options also include surgery and medications. It is important to note that proper management of DME relies on the treatment of diabetes. No treatment method will be successful unless diabetes is kept under control.
Causes of Condition
DME develops in patients with diabetes. If the disease is not managed properly, it can cause diabetic retinopathy (DR), which can lead to DME.
Diabetes prevents the body from using sugar effectively. As a result, an excessive amount of sugar is left in the blood. This leads to serious problems with the different organs in the body. It can cause nerve damage. It can also damage blood vessels, including those in the eye area. Diabetes is now the leading cause of blindness in the world.
In DR, the blood vessels begin to form in the retina and the vitreous. These new blood vessels can leak blood. When this happens, the patient will develop DME.
Not all patients display symptoms of DME. This is one of the reasons why many cases are caught in the advanced stages.
If a patient does develop symptoms, one of the first is blurred vision. It is important to note that this symptom can be caused by many different conditions. But if a patient has already been diagnosed with DR, there is a chance that it is due to DME.
Other symptoms include a cloudy vision and seeing faded colours. The patient may notice that the colours of objects no longer appear as striking as they once were. Severe cases lead to total vision loss. Blindness can occur quickly. As such, patients need to be screened on a regular basis to prevent their condition from progressing.
Who to See and Types of Treatments Available
Many patients with DME are cared for by their primary care doctor or diabetes specialist. If they develop conditions related to the eyes, their medical team will also include an eye specialist.
The first step in diagnosing DME is through a special eye exam. For this test, eye specialists use an optical coherence tomography (OCT) machine. The doctor will check for any swelling and fluid in the retina. The doctor will also record the thickness of the retina and note any abnormalities.
If the doctor suspects DME, he or she will also check the blood vessels in the eyes. In this procedure, the patient is injected with a special dye. The doctor will then take images of the blood vessels located in the back of the eye. This test can show if new blood vessels have formed. It can also confirm if the blood vessels are leaking blood. The patient’s protein, lipid, and triglyceride blood levels are also measured.
The doctor will start treatment if DME is confirmed. Treatment options can include medications, surgery, and laser procedures. The doctor will decide on the best treatment for the patient depending on the severity of the condition. The damage caused by DME can be reversed if the condition is caught and treated early. If caught in the advanced stages, the damage becomes permanent. When this happens, treatment will focus on preventing the condition from getting worse.
Medications used to treat DME help prevent it from progressing. Laser treatments, on the other hand, are used to seal off the leaking blood vessels. This treatment also prevents the condition from worsening because it keeps fluid from building up in the retina.
The doctor may also recommend surgery in some cases. This often involves removing the vitreous. This is a gel-like substance that fills the eye’s central cavity. The surgery helps reduce vitreoretinal traction. It also helps increase retinal oxygenation.
It is important to note that none of these treatments will work if diabetes is not kept under control. Controlling blood sugar levels often involve insulin therapy. It is also important for patients to adopt a healthy lifestyle. Eating a well-balanced diet and exercising regularly are highly recommended.
Macular Edema in Diabetes: Emmanouil Mavrikakis, MD PhD; https://emedicine.medscape.com/article/1224138-overview
Diabetic Retinopathy Treatment: Kierstan Boyd; American Academy of Ophthalmology; https://www.aao.org/eye-health/diseases/diabetic-retinopathy-treatment
Facts About Macular Edema; National Eye Institute: https://nei.nih.gov/health/macular-edema/fact_sheet