Diabetic Macular Edema: Causes, Symptoms and Treatment
In order to be diagnosed with diabetic macular edema, you must first have diabetic retinopathy. This condition arises when the blood vessels in the eyes become damaged due to high blood sugar. With diabetic retinopathy, the retinal blood vessels change over time, becoming more abnormal in nature. If diabetes is not controlled, the vessels may start to leak fluid–one of the primary signs of DME.
Fluid collects in the macula, a light-sensitive area of the retina responsible for the detailed vision needed for reading, driving or identifying faces. Macular edema happens when fluid builds up in this area and starts to seep out. As a result, the macula is unable to detect light accurately or perform its job providing sharp, straight-ahead vision. If left untreated, DME can lead to vision loss.
DME is prevalent in people with persistent diabetes, very high blood pressure, fluid retention, hypoalbuminemia (low levels of a major protein in the body fluids) and hyperlipidemia (high concentrations of fat in the blood). DME is the most common eye condition associated with diabetic retinopathy.
There are two types of DME: focal DME, which develops due to abnormalities in retinal blood vessels, called microaneurysms, and diffuse DME, which develops when retinal capillaries at the back of the eye widen.
Signs and Symptoms
Not all cases of DME show symptoms. In fact, some people may not even know they have diabetic retinopathy (or diabetic macular edema) until vision loss occurs. For that reason, it is important for diabetics to visit the eye care clinic yearly or when they notice any unusual problems with their eyes.
Symptoms associated with DME include:
- Blurry vision
- Double vision
- Floaters (tiny shadows of the vitreous of the eye)
- Blindness, if left untreated
If you experience any of these symptoms, you should visit your eye care clinic right away.
Your Kansas City eye doctor will perform a visual acuity test and a dilated eye exam to evaluate general eye health. If these tests come back with abnormal results, your eye care provider will perform a fluorescein angiogram, which uses a special dye to illuminate parts of the retina for photographing. Another test used to detect DME is the optical coherence tomography, which captures retinal fluid and swelling using a special camera.
Treatment
If you suspect you have diabetic retinopathy or DME, it’s important to see a doctor as soon as possible. Early detection is critical for treating these conditions and minimizing your risk of vision loss.
The ultimate goal of treatment for DME is to decrease macula leakage. In mild cases, this may be achieved by injecting the eye with drugs, such as Avastin, Eylea and Macugen, among others. This form of treatment is referred to as Anti-VEGF injection therapy. Several injections may be necessary to get the leakage under control.
In more severe cases, the leakage must be controlled with laser photocoagulation. The specific type of laser procedure varies depending on the type of DME, focal or diffuse.
Some patients with severe bleeding due to diabetic retinopathy require a surgical treatment known as vitrectomy. This surgery involves removing the vitreous gel in the eyes that may be clouding vision.
Prevention is the best defense against diabetic retinopathy and diabetic macular edema. Be sure to always schedule regular eye exams if you have diabetes, and make positive lifestyle changes to keep the disease under control, including taking prescribed medications, exercising and eating a nutritious diet.
Please contact our office today to schedule a comprehensive eye exam, and we will help you make a plan to protect your eyes and your vision.