Diabetic Macular Edema

By Malav Joshi, MD

Chesapeake Retina Centers

. http://www.chesapeakeretina.com

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Diabetic Macular Edema

Macular edema occurs when fluid accumulates and causes the central part of the retina, called the macula, to swell up. The macula is the part of the retina responsible for our central or straight ahead vision and allows us to see details in clear focus.

Macular edema can occur as a result of a variety of conditions including, diabetes, macular degeneration, retinal vein occlusions, after cataract surgery, and a variety of other conditions. This article will discuss diabetic macular edema (DME).

The retina needs good blood flow in order to function properly, which is provided by a network of tiny blood vessels (capillaries) that run within the retinal tissue. If you have diabetes, the walls of these tiny blood vessels can deteriorate and weaken over time in a way that allows fluid to leak out into the surrounding retina, causing it to swell up like a sponge.

When the macula swells up, the vision can become blurred or wavy, color vision can fade, contrast sensitivity can decrease, or you can develop gray or black spots in the field of vision. Vision loss from DME can vary in severity and tends to occur gradually over time. Longer duration of diabetes, poor blood sugar control, and high blood pressure can all increase the odds of developing DME.

If it is not diagnosed and treated early, macular edema can become chronic and difficult to treat, whereby vision loss can become irreversible. This is why it is crucial to get your eyes examined regularly, as recommended by your eye doctor.

Without achieving good control of your blood sugar, blood pressure, and cholesterol, the success rate of any treatment is often reduced. Treatments offered by your retinal surgeon may include injections of medicines into the eye, laser, or a combination of both. Laser helps to cauterize and seal leaky vessels and may have to be repeated a few times. However, eye injections (intravitreal injections) are the mainstay of treatment. They are done in the office after your eye is numbed with topical anesthetic. The injection is relatively quick and painless, however repeated injections are often needed.

When diabetes and blood pressure are well controlled, these treatments can be quite effective and can greatly decrease the chance of losing your vision. However, it is very important to stick with your treatment plan and maintain regular follow-ups with your retinal surgeon while you are under treatment in order to see how effective each treatment is and adjust it if needed. This will give you the best chance of maintaining your sight and independence over the long term.