Understanding the Health Risks of Diabetic Macular Edema

Understanding the Health Risks of Diabetic Macular Edema

Precio Daramola |Mar 22, 2021

Diabetic Macular Edema Explained

Diabetic macular edema (DME) is a complication of diabetes that occurs when excess fluid starts to build up in the eye's macula. The macula is the part of the eye that allows us to focus and see fine details, and it is located in the retina, which is full of blood vessels. High blood sugar levels can damage the retina's blood vessels. The damaged blood vessels then begin to leak fluid, thereby causing swelling and other complications. This damage is called retinopathy and generally develops over time.

What Causes Diabetic Macular Edema?

As earlier stated, DME usually occurs due to high blood sugar levels. Other factors such as high blood pressure and high cholesterol levels can also contribute to blood vessel damage. In other instances of diabetes, pregnancy may also increase the risk of developing DME.

Risk Factors

Since DME results from high blood sugar levels, it is common for people with diabetes, especially uncontrolled diabetes, to be at risk for DME. Additional risk factors that can lead to DME include:

Associated Symptoms of Diabetic Macular Edema

In its early stages, there may be no symptoms. However, if you have diabetes, it is important to see an eye care doctor every year so they can examine your eyes for any changes. If you also notice any sign of retinopathy or DME, early treatment can prevent or restore vision loss. Let’s take a look at some of the common signs and symptoms of diabetic macular edema:

  • Blurry or blocked central vision
  • Distorted or "wavy" central vision (called metamorphopsia)
  • Seeing floaters or strings of floaters in your vision
  • Blind or dark areas or spots in your field of vision
  • Difficulty reading at any distance
  • Colors appear more washed out than usual

When to Call the Doctor

Call your eye doctor right away if you notice any of the above symptoms. Be sure to tell your eye doctor if you have any of the following symptoms:

  • Blurry vision
  • Seeing colors that look washed out
  • Seeing more floaters in your vision
  • Double vision

Diagnosis and Different Treatment Options

Diabetic macular edema can be diagnosed through a comprehensive eye examination. There are effective treatments available for DME. Be sure to talk to your doctor to find the right option that will work for you. If you have received a DME diagnosis, ensure that you start treatment quickly to help prevent long-term eye damage and vision loss. Your doctor can recommend any of the following treatments:

Laser Therapy

Laser therapy involves the use of tiny lasers to target damaged areas in the retina. This process seals leaking blood vessels and prevents abnormal blood vessel growth. Laser therapy is effective in maintaining your current vision level and helps prevent further loss of vision. You’ll likely need several laser treatments overtime to repair eye damage and may require additional treatments if more eye damage occurs.

Anti-VEGF Shots

When you have DME, your body tends to produce a protein called VEGF in excess. When this happens, your blood vessels begin to grow too quickly; so, they are weak and leak blood and fluid into your retina and macula.

There are three types of anti-VEGF medicines usually used for DME; they include aflibercept (Eylea), bevacizumab (Avastin), and ranibizumab (Lucentis). These Anti-VEGF shots help to inhibit the effects of the VEGF protein. However, anti-VEGF shots may not be helpful for everyone and should not be used during pregnancy.

Focal-Grid Macular Laser Surgery

This treatment type works by sealing blood vessels in your retina to slow leaking and bring down swelling. If you have DME in both eyes, your doctor will treat one eye at a time, usually within a few weeks. In some cases, a laser may be used along with anti-VEGF shots if the shots alone are not helping.

Corticosteroids

These drugs are often called steroids and are used to target inflammation. They are usually prescribed to help lessen swelling in your retina. Steroids are usually not as effective as anti-VEGF shots, and they can cause other eye problems, like cataracts and glaucoma. They are not traditionally given as first treatment.

NSAID Eye Drops

Doctors sometimes use eye drops as a preventive measure for DME before or after you have eye surgery. These drugs are called non-steroidal anti-inflammatory drugs (NSAIDs) because they help fight inflammation like steroids but do not have the same side effects. Doctors usually prescribe NSAIDs to prevent or ease swelling.

Can Diabetic Macular Edema Be Prevented?

You may not be able to prevent macular edema if you have diabetes, a pre-existing eye condition, or have suffered an eye injury in the past. However, you can follow the nutrition and lifestyle recommendations from your health care provider to avoid developing diabetes in the first place. You will likely be advised to do the following:

  • Keep your blood sugar level under control. Check your blood sugar level several times a day (ask your doctor exactly how often). The American Diabetes Association recommends people with diabetes keep their A1C levels under 7%.
  • Stop smoking or do not start. Ask your doctor for help quitting. Smoking increases your risk of diabetic retinopathy, age-related macular degeneration, and blocked retinal blood vessels. All those toxins damage the eyes’ tiny vessels.
  • Exercise often. Try not to go more than two days between exercising. If you do, the glucose-metabolizing effects of physical exercise will wear off.
  • Eat healthy. Follow your doctor's nutritional guidelines but, in general, avoid junk food and fast food, and try to eat more fresh fruits and vegetables, especially dark, leafy greens such as spinach, kale, and collard greens.

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