Diabetic Macular Edema: What is It?

Created June 16, 2016 by in Retina Specialist, Retinal Vascular Disorders
Diabetic Retinopathy manifests in one of two ways for patients: bleeding, and the accumulation of fluid within the retina.  The most common loss of vision for persons less than 65 years of age in the US is from this accumulation of fluid within the center of the retina, otherwise known as diabetic macular edema.  This can be easy to miss for a patient.  Whereas bleeding into the vitreous, a vitreous hemorrhage, presents obviously to the patient as large new floaters obscuring one’s vision, diabetic macular edema is more subtle and the patient may only notice a little distortion in the center of one’s vision.   When looking at straight lines, a perceived waviness can be an indication of this diabetic macular edema.

The longer the macular edema is present the more likely permanent vision loss will occur from the disruption of flow of nutrients to the photoreceptors within the retina.  The photoreceptors are the brain of the retina so to speak and their death results in permanent vision loss.  It is for this reason that we as retinal specialists aggressively treat the accumulation of fluid within the retina.  In the beginning of retinal treatment 50 years ago only laser was available for the treatment of diabetic retinopathy.  Today the injection of medicinal agents within the eye has largely replaced laser as the primary treatment option.  This is understandable since these injections work very well and usually there is no damage at all to the retina with this treatment, whereas focal laser can result in some damage to the retina and a resulting scotoma, or a blank spot in one’s vision, is possible.

There are several medicinal agents injected within the eye for macular edema.  The two main categories are certain proteins which are referred to as antivegf agents and steroids.  Steroids typically are potent but can also have some serious negative effects and so the antivegf agents are the first line of treatment.  There are several different antivegf agents available and they work from four to eight weeks.  These medicines have revolutionized the treatment of diabetic macular edema and save many persons vision daily throughout the world.  The best way to see if this complication of diabetes is present for you is to be seen by a retinal specialist and examined with very accurate diagnostic equipment to take quick images of your retina.

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