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WHAT TO KNOW ABOUT DIABETIC MACULAR EDEMA
Diabetic macular edema is a leading cause of vision loss in people with diabetes. If you’ve been diagnosed with this eye disease, you need to know which options can protect your sight.
If you’ve recently been diagnosed with diabetic macular edema, or DME, you may be wondering how your condition will progress. Although diabetic eye diseases, including DME, are the leading cause of irreversible blindness in working-age Americans, according to the National Eye Institute (NEI), there are steps you can take to treat this diabetes complication and prevent further vision loss. Use this guide to learn more about DME.
WHAT IS DME?
People who have type 1 or type 2 diabetes may develop a complication called diabetic retinopathy, or damage to the small blood vessels of the eye’s retina. DME occurs when fluid from these damaged blood vessels leaks into the macula, an area in the center of the retina that helps us see objects directly ahead of us, and causes swelling.
The primary risk factor for diabetic retinopathy and eventual DME is uncontrolled blood sugar. Having high blood pressure or high cholesterol may also increase your risk of vision loss if you have DME, according to the NEI. A study published in 2014 in the journal JAMA Ophthalmology found that among people with diabetes age 40 and older, approximately one in 25 may have DME in at least one eye.
While diabetic retinopathy often advances slowly, DME can progress much faster, says Daniel S. Casper, MD, PhD, an ophthalmologist with Columbia Medical Center in New York City. At first you might not experience many symptoms, but eventually, the central field of vision can become wavy and blurred. “As fluid builds up in [the center of the macula], the retina becomes boggy, reducing the ability to focus,” Dr. Casper explains. Some people say that letters and shapes look twisted or misshapen.
HOW IS DME Diagnosed and Monitored?
New technology has completely changed how DME is found in patients, says Casper. Previously, doctors could detect the presence of swelling in the eye, but they had no way of knowing how much swelling had accumulated or whether the treatments were effective. That’s all changed over the last decade, he says.
Now, a noninvasive test called optical coherence tomography can measure the thickness of the retina using light, he says, which detects whether someone needs to be treated for DME, and then, whether the treatment they’re undergoing is working.
“There’s a certain amount of urgency with getting people with DME evaluated and treated,” says Casper. “The sooner [DME] is identified and treated, the better a patient does. If you wait until your vision is impacted, you may not get back all of your sight.”
How Is DME Treated?
If you’ve been diagnosed with DME, one of the most important steps you can take is to lower your hemoglobin A1C level, the measure of your blood sugar average during a three-month period. Lowering your A1C can help slow the advancement of DME and protect your vision, says Casper.
Your doctor may suggest eye treatments as well. Up until relatively recently, explains Casper, the only option was laser treatments, which seal off capillaries to stop leakage, but now eye injections are available that stymie blood vessel growth and leakage. People may need these injections over the course of many years, explains Casper.
Work with your doctor to find the right treatment for you — be it lasers, injections, or a combination of both, he says.
The bottom line: If you have DME, don’t wait to seek treatment. “You can stop the progression of the disease, but you can’t get lost vision back,” Casper explains.
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