Diabetes affects millions of people globally, and when poorly managed, it can lead to a range of serious complications.

One of the most concerning complications is diabetic macular edema (DME), a condition that can severely affect vision. Understanding DME, its symptoms, and available treatment options is crucial for taking proactive steps to protect your eyesight.

What Is Diabetic Macular Edema (DME)?

Diabetic macular edema occurs when high blood sugar levels cause damage to the blood vessels in the retina, leading to fluid leakage. This fluid buildup causes swelling in the macula, the central part of the retina responsible for sharp vision. As a result, individuals with DME experience blurred or distorted vision. If left untreated, DME can lead to permanent vision loss.

Approximately 3.8% of people with diabetes will develop DME over time, making it an important issue to monitor.

Causes of Diabetic Macular Edema

The main cause of DME is uncontrolled diabetes. When blood sugar levels remain high for extended periods, they can damage the tiny blood vessels in the retina, leading to diabetic retinopathy. The leaking fluid from these vessels leads to macular swelling and DME. The best way to prevent DME is to keep blood sugar levels well-controlled and minimize damage to the retinal blood vessels.

Symptoms of Diabetic Macular Edema

DME may not present any noticeable symptoms in its early stages, which is why regular eye exams are essential for those with diabetes. As the condition progresses, the following symptoms may appear:

• Blurred or distorted central vision
• Difficulty seeing clearly in bright sunlight or at night
• Trouble distinguishing colors
• Fluctuating vision (sometimes better, sometimes worse)

If you notice any of these changes, it’s important to see an eye doctor as soon as possible. DME can worsen quickly and cause permanent vision damage without timely treatment.

Diagnosing Diabetic Macular Edema

An eye care professional can diagnose DME with a comprehensive eye exam. Tests such as optical coherence tomography (OCT) and fluorescein angiography are often used to evaluate the extent of retinal swelling and the condition of the blood vessels. Early detection is key to managing DME effectively.

Treatment Options for Diabetic Macular Edema

The primary focus of DME treatment is controlling blood sugar levels, but additional therapies may be required to manage the condition and prevent further vision loss:

1. Medications: Anti-VEGF (vascular endothelial growth factor) injections such as Avastin, Lucentis, or Eylea can reduce fluid leakage and prevent abnormal blood vessels from growing. Corticosteroid injections, like triamcinolone acetonide, can help reduce swelling and inflammation.
2. Laser Therapy: Focal or grid laser treatments can seal leaking blood vessels and prevent additional fluid leakage. These treatments are especially useful in mild to moderate DME cases.
3. Surgery: In rare cases, surgery may be necessary if swelling is severe and other treatments fail. A vitrectomy, which removes the vitreous gel from the eye, may be recommended to treat significant swelling or bleeding.
4. Vision Aids and Rehabilitation: For those who have experienced vision loss, low vision aids such as magnifiers or specialized glasses can help improve visual function. Vision rehabilitation therapy can also provide patients with tools and techniques to live more independently despite vision impairment.

Preventing Diabetic Macular Edema

While DME may not always be preventable, certain steps can reduce the risk:

• Manage blood sugar levels: Maintaining stable blood glucose levels is the most important measure to prevent DME and other diabetes-related complications.
• Regular eye exams: Annual check-ups with an ophthalmologist are essential to detect DME early, even if you don’t notice any symptoms.
• Control blood pressure and cholesterol: Keeping your blood pressure and cholesterol within healthy ranges can also help prevent DME and other related complications.
• Adopt a healthy lifestyle: Eating a balanced diet, exercising regularly, and avoiding smoking are all important for eye health and reducing the risk of DME.

Next Steps

If you have diabetes and notice any changes in your vision—or if it’s been a while since your last eye exam—make an appointment with your eye doctor. Early detection of diabetic macular edema is crucial for preventing severe vision loss. Since DME can develop without noticeable symptoms, regular eye exams are especially important.

By effectively managing your diabetes and staying proactive with eye health, you can reduce the risk of DME and maintain a higher quality of life.