Diabetes is a widespread condition that affects millions of people globally. If not well-managed, it can lead to various complications, including diabetic macular edema (DME), a serious eye condition that can significantly affect vision.

Understanding DME, its symptoms, and the available treatments can help individuals take steps to protect their eyesight.

What Is Diabetic Macular Edema (DME)?

Diabetic macular edema is a condition that affects the macula, the part of the retina responsible for sharp, central vision. DME occurs when high blood sugar levels damage the blood vessels in the retina, causing them to leak fluid. This fluid buildup leads to swelling in the macula, which causes blurred or distorted vision. In severe cases, untreated DME can result in permanent vision loss.

Around 3.8% of individuals with diabetes will develop DME over time, making it a significant concern for those living with the condition.

Causes of DME

The primary cause of diabetic macular edema is uncontrolled diabetes. Long-term elevated blood sugar levels damage the tiny blood vessels in the retina, leading to a condition known as diabetic retinopathy. The leaking of fluid from these damaged vessels causes swelling in the macula, resulting in DME. The best preventive measure is maintaining strict control over blood sugar levels to minimize damage to the retinal blood vessels.

Symptoms of Diabetic Macular Edema

In its early stages, DME may not show any noticeable symptoms. This is why regular eye exams are crucial for individuals with diabetes. As the condition progresses, you might experience the following symptoms:

• Blurred or distorted central vision
• Difficulty seeing in bright sunlight or at night
• Trouble distinguishing colors
• Fluctuating vision—vision may improve or worsen unpredictably

If any of these symptoms occur, it’s essential to visit an eye doctor promptly. DME can worsen rapidly and lead to irreversible vision loss without proper treatment.

Diagnosing Diabetic Macular Edema

An eye care professional can diagnose DME through a thorough eye exam. Tests such as optical coherence tomography (OCT) and fluorescein angiography help assess the extent of retinal swelling and evaluate the condition of blood vessels in the retina. Early detection is vital for effective management of the condition.

Treatment Options for Diabetic Macular Edema

The primary treatment strategy for DME is managing diabetes and maintaining stable blood sugar levels. However, once DME develops, additional treatments may be necessary to control the condition and preserve vision:

1. Medications: Anti-VEGF (vascular endothelial growth factor) injections, such as Avastin, Lucentis, or Eylea, are commonly used to reduce fluid leakage and inhibit the growth of abnormal blood vessels. Corticosteroid injections, like triamcinolone acetonide, can also be used to reduce inflammation and swelling.
2. Laser Therapy: Focal or grid laser therapy can be employed to seal leaking blood vessels and prevent further fluid leakage, which helps preserve vision, particularly in mild to moderate cases of DME.
3. Surgery: In rare cases where swelling is severe and other treatments are ineffective, surgery may be necessary. A vitrectomy, which removes the vitreous gel from the eye, can be performed to address significant swelling or bleeding.
4. Vision Aids and Rehabilitation: For those who have experienced vision loss, glasses or low vision aids such as magnifiers may help improve vision. For individuals with significant vision impairment, rehabilitation therapy can teach adaptive techniques to navigate daily life independently.

Preventing Diabetic Macular Edema

While it may not be entirely possible to prevent DME, the following steps can reduce the risk:

• Manage blood sugar levels: The most important factor in preventing DME and other diabetic complications is keeping blood glucose levels under control.
• Regular eye exams: Individuals with diabetes should schedule annual eye exams with an ophthalmologist to detect DME and other potential eye issues early.
• Control blood pressure and cholesterol: Keeping blood pressure and cholesterol within healthy ranges can help prevent DME and other complications.
• Healthy lifestyle choices: A nutritious diet, regular exercise, and quitting smoking all contribute to better eye health and can help reduce 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 in preventing severe vision problems and preserving eyesight for years to come. Regular eye exams are especially important, as DME may develop without noticeable symptoms.

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