What is Diabetic Macular Edema?
Diabetic Macular Edema (DME) is an accretion of fluid in the macula part of the retina which controls our most detailed vision abilities—due to leaking blood vessels. In order to develop DME, patient must first have diabetic retinopathy. Whereas Diabetic retinopathy is an ailment that destroy the blood vessels in the retina, ensuing in vision impairment. If Left untreated, these blood vessels begin to build up pressure in the eye and leak fluid, causing DME. DME usually takes on two forms:
✔️Focal DME, which occurs due to abnormalities in the blood vessels in the eye.
✔️Diffuse DME, which happens because of widening/swelling retinal capillaries (very thin blood vessels).
Diabetic Retinopathy and DME are most common complications for diabetics. Roughly 11% of the U.S. inhabitants are diabetic, and about 33% of those diabetic’s subjects have eye distress because of it. Diabetic retinopathy is instigated by ongoing damage to the small blood vessels of the retina. The seepage of fluid into the retina may lead to inflammation of the surrounding tissue, including the macula.
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DME is a major cause of vision loss in subjects with diabetic retinopathy. Treatment conditions such as blood sugar control and high blood pressure increase the risk of blindness in people with DME. DME can occur at any stage of diabetes Retinopathy, but the disease can occur later.
Experts estimate that 9.3 million Americans suffer from diabetes retinopathy whereas about 881,000 also have DME. A recent clinical Investigation has identified that non-Native Americans were three times more likely to develop DME than white, most likely due to the higher incidence of diabetes in the African American population.
Diabetic Macular Edema (DME) is an impediment of diabetes. Subjects with type 1 or type 2 diabetes can develop DME. DME happens when excess fluid starts to accumulate in the macula of the eye. With Macula we can see the fine details. It’s located in the center of the retina, the lining at the back of the eye that’s full of blood vessels.
When excess fluid aggregate in the macula, it leads to vision problems. DME usually progresses over time. High blood sugar levels can mutilate the blood vessels in the retina. Damaged blood vessels can leak fluid, which causes swelling and other issues. This impairment is called retinopathy. There are several ways to treat DME. It is easy to treat if it is regularly checked by an ophthalmologist.
Sign and Symptoms of DME
At the initial stage, no symptoms may be observed. If you have diabetes, you should see your eye doctor every year to have your eyes checked for changes. If there’s any sign and symptoms of retinopathy or DME, early treatment can avert or restore vision loss.
Make sure to inform your ophthalmologist, if you have any of the following Sign and symptoms:
✔️blurred vision
✔️seeing colours that look washed out
✔️seeing more spots in your vision
✔️binary vision
What Causes DME
Typically, if blood sugar levels rise, blood vessels in the eye are damaged, and the risk of DME increases. Working with your healthcare team to keep your blood sugar levels as close to target as possible is a key part of keeping your eyes healthy. High blood pressure & high cholesterol levels can also subsidize to blood vessel damage. In some cases of diabetes, pregnancy can upsurge the risk of emerging DME. Your physician may indorse more frequent eye exams amid pregnancy.
Categories of DME
DME is sometimes classified based on the level of inflammation in the retina. A thicker retina means there’s more swelling, and this usually means greater vision loss. It may also be distinct by the position of damage to the blood vessels. In some cases, it’s limited to one area. In other cases, the impairment is more prevalent throughout the retina.
Amid eye Investigation, Ophthalmologist may perform various tests on your eyes. The tests assess any vision loss and show any damage to blood vessels or amount of fluid buildup (swelling) in the retina.
Common eye tests to screen for DME or assess eye damage are:
✔️Optical coherence tomography (OCT). This test measures any swelling in the retina.
✔️Fundus imaging. This test takes thorough pictures of the retina to identify any irregular blood vessels.
✔️Fluorescein angiography. For this test, dye is injected into your arm or hand to highlight the blood flow in the retina.
For all tests, you’ll be given eye drops to make your pupils larger (called pupil dilation). This allows ophthalmologist to see more of the retina. Other than some light sensitivity from the pupil dilation, you won’t feel any discomfort during the testing.
When caught early and monitored by an ophthalmologist, treatment can help prevent further loss of vision. Treatment may even reestablish lost vision. If Left untreated, vision can knowingly worsen within a few months.
Risk factors
For subjects with type 1 or type 2 diabetes, there are added risk factors that can lead to DME. These risk factors include:
✔️poor blood sugar management
✔️high cholesterol
✔️high blood pressure
✔️kidney disease (nephropathy)
✔️sleep apnoea
✔️pregnancy
Prevention
It’s never too late to consult treatment options with your ophthalmologist. If you have a diagnosis of DME, starting treatment swiftly can help thwart long-term eye damage & vision loss. Taking precautionary action can make a big transformation when it comes to shielding your vision. Take care of your visions by doing the following:
✔️See your ophthalmologist for annual check-ups.
✔️Contact your ophthalmologist as soon as you notice any vision changes.
✔️Work with your diabetes care team to manage your blood sugar levels effectively.
✔️Take steps to keep your blood pressure and cholesterol levels in target.
If you have difficulty adjusting your blood pressure, tell your doctor. They may recommend lifestyle changes, medication, or other steps that can help you keep your blood sugar levels in a healthy range.
Treating DME
There are operative treatments available for DME. Annual eye exams can quickly detect changes. If you have DME, treatments can protect your eyesight and may converse vision loss. Your ophthalmologist may recommend using more than one type of treatment.
Laser therapy
This treatment is usually recommended by an ophthalmologist in a clinical setting. Laser therapy uses tiny lasers to target damaged areas in the retina. This method closes the blood vessels and prevents the spread growth. Laser treatment helps maintain current vision and prevent vision loss. Over time, laser treatment is needed to repair the damage to the eye You may require additional treatments if more eye damage occurs.
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Injectable medications
There are two groups of injectable medications: anti-VEGF and steroids. Within each group, there are several types available. Your ophthalmologist will determine the specific medication and frequency of treatment that’s right for you. Your ophthalmologist injects the medication into your eye with a very thin needle. They will numb your eye to prevent any pain when they give this medication.
Anti-VEGF stands for “anti-vascular endothelial growth factor.” Medications in this category help prevent abnormal blood vessel growth that could further damage the eye. They also reduce swelling. In general, anti-VEGF medications:
✔️Recent studies show good success in improving vision
✔️help decrease the amount of fluid that leaks into the retina
✔️have a low risk of difficulties and are considered safe
Anti-VEGF injections aren’t usually painful. If needles make you anxious, you can talk to your doctor about options to help you feel calm during the procedure.
Steroids are another option to treat DME. Steroids may:
✔️help decrease swelling of the retina and recover vision
✔️be used if anti-VEGF medications no longer work
However, steroids may upsurge the risk of cataracts in some cases. Your doctor will discuss whether the benefit of using this therapy overshadows the risk. Steroid treatment for DME may be accessible as single injections or implants that release the medication over time.
Closing Remarks
Diabetic macular edema (DME) is a controllable condition. Several effective treatment options are available. You can save your eyesight or restore lost vision. Seeing your ophthalmologist at least every year is an important step in taking care of your eyes and overall well-being. Early detection is the best way to prevent rapid loss.
