A look at the emerging therapies and best clinical practices in treating diabetic macular edema.
- Ranibizumab Monotherapy & DME. For many years it has been established that vascular endothelial growth factor plays a role in the creation of retinal ischemia and increased vascular permeability that ...
- Alternative Treatment Prospects. ...
- Future Therapeutic Prospects. ...
What is DME and can it be cured?
What is DME? Can it be cured? Diabetic macular edema is a complication of diabetes that can cause blindness. There is no cure for diabetic macular edema, but treatment can help slow progression of the condition and prevent blindness.
How do doctors treat diabetic macular edema (DME)?
Doctors treat diabetic macular edema (DME) in two ways. First, they tackle what's causing it, like high blood sugar or high blood pressure. Just keeping your levels close to normal can stop eye damage from happening or getting worse. The next step is to heal your retina. You should see an ophthalmologist or a retina specialist for treatment.
Can laser treatments help my DME?
Lasers can seal blood vessels in your retina to help slow leaking and bring down swelling. If you have DME in both eyes, your doctor will treat one eye at a time, with a few weeks in between. Usually you need just one treatment for each eye. Your doctor might try a laser along with anti-VEGF shots if the shots alone aren't helping.
How do you treat DME in one eye?
If you have DME in both eyes, your doctor will treat one eye at a time, with a few weeks in between. Usually you need just one treatment for each eye. Your doctor might try a laser along with anti-VEGF shots if the shots alone aren't helping.
What is the best treatment for macular edema?
Corticosteroid (steroid) treatments, which reduce inflammation, are the primary treatment for macular edema caused by inflammatory eye diseases. These anti-inflammatory drugs are usually administered via eye drops, pills, or injections of sustained-release corticosteroids into or around the eye.
Does DME go away?
Sometimes, DME goes away on its own. But most of the time, it's a chronic condition that requires management. With the right treatment, you can help protect your eyes from long-term damage and potentially experience improvements in your vision.
Can DME be reversed?
Although DME is reversible in its early stages, chronic edema may lead to irreversible changes in the retina and become debilitating for the patient. If the disease is untreated, 20% to 30% of patients with DME will lose at least 3 lines of vision within 3 years.
How do you stop DME?
How to Prevent DMEMaintaining good blood sugar, blood pressure, and cholesterol control helps prevent DME.Receiving a comprehensive dilated eye exam at least once a year, or more often as directed by the eye doctor.Pregnant woman with diabetes should have a comprehensive dilated eye exam as soon as possible.More items...
How many injections do you get for macular edema?
All of the studies now show that, on average, patients need between six to eight shots a year. Some patients may need fewer, some patients more, but long-term, sustained treatment is important for disease control.
Can retinal edema be cured?
The condition cannot be cured, although it can be treated. Retinal capillaries may be leaky for a number of different reasons depending on the underlying disease or type of condition.
Is there a cure for diabetic macular edema?
Nowadays, the standard of care for our patients that have diabetic macular edema involves medicines that are injected into the eye in order to help them recover as much vision as possible. Once we see patients with diabetic macular edema, the average patient is going to need treatment for around a year.
How do you get rid of fluid behind the retina?
Treatment of Fluid Behind the RetinaMedications such as corticosteroids or anti-inflammatory drugs aim to quell inflammation. ... Sometimes, it may be necessary to use a surgical approach such as a vitrectomy in which the jelly-like substance that normally fills the eye is removed.More items...•
What is the treatment for bleeding behind the eye?
Observation is commonly the only treatment required for a vitreous hemorrhage. The blood usually clears on its own, within several months. The underlying cause of the bleed needs to be treated if necessary. This can be done with laser treatments, cryotherapy, and anti-VEGF injections in the office.
How is DME diagnosed?
Optical coherence tomography (OTC) is one of the best ways to test for DME. It's like an ultrasound, but it uses light waves instead to create very fine, detailed images of tissues inside your eye. OTC can show the thickness of different layers in your retina and find problems that other tests can't.
Can macular edema be fixed?
Macular edema cannot be cured but can be treated effectively if diagnosed early. Vision can be better preserved with early treatment of macular edema and the underlying condition causing it. Recovery from macular edema is slow and gradual and may even take months.
How serious is diabetic macular edema?
Sometimes, tiny bulges (microaneurysms) protrude from the vessel walls, leaking or oozing fluid and blood into the retina. This fluid can cause swelling (edema) in the central part of the retina (macula). This is a serious eye complication called diabetic macular edema that can cause vision problems or blindness.
What is the test for DME?
Common eye tests to screen for DME or assess eye damage are: Optical coherence tomography (OCT). This test measures any swelling in the retina.
Where is the DME located?
It’s located in the center of the retina, the lining at the back of the eye that’s full of blood vessels. When excess fluid builds up in the macula, it causes vision problems. DME generally develops over time. High blood sugar levels can damage the blood vessels in the retina.
What is the complication of diabetic macular edema?
People with type 1 or type 2 diabetes can develop DME. DME occurs when excess fluid starts to build up in the macula of the eye. The macula allows us to focus and see fine details. It’s located in the center of the retina, the lining at the back of the eye that’s full of blood vessels.
Can diabetes cause DME?
High blood pressure and high cholesterol levels can also contribute to blood vessel damage. In some cases of diabetes, pregnancy can increase the risk of developing DME. Your doctor may recommend more frequent eye exams during pregnancy.
Can a pupil dilation help with vision loss?
This allows your eye care doctor to see more of the retina. Other than some light sensitivity from the pupil dilation, you won’ t feel any discomfort during the testing . When caught early and monitored by an eye care doctor, treatment can help prevent further loss of vision. Treatment may even restore lost vision.
Is macular edema a manageable condition?
Diabetic macular edema (DME) is a manageable condition. Several effective treatment options are available. Maintaining eyesight or recovering lost sight is possible. Seeing your eye care doctor at least every year is an important step in taking care of your eyes and overall well-being.
Is diabetic macular edema a complex condition?
Treating patients with diabetic macular edema (DME) is a complex endeavor. But for the past 10 years, studies from the DRCR Retina Network have provided clinicians with valuable guidelines and insight into this leading cause of visual loss in working-age adults.
Can anti-VEGF be used for DME?
More recently, the network confirmed that anti-VEGF drugs could be used as rescue therapy following observation or laser for DME with good visual acuity (VA).
What is the best treatment for DME?
Choices may include anti–vascular endothelial growth factor (anti-VEGF) injections, steroid implants, and/or laser treatments. Sometimes, a wait-and-see approach may be recommended as the best course of treatment, too, if you have center-focused DME and your vision is still good.
How many people with DME do not respond to anti-VEGF?
In fact, studies show that anywhere from 20% to 60% of patients with DME do not respond to them. If your vision does not improve after anti-VEGF treatment, your doctor may call you a "suboptimal responder.". But don't worry, there are other effective treatments (Also: We think you're optimal in every way!).
How to treat DME?
The main treatment for DME is anti-VEGF injections into the eye. These injections stop the activity of vascular endothelial growth factor (VEGF) to promote the growth of blood vessels. This can reduce leakage from damaged blood vessels and slow the progression of DME. Anti-VEGF drugs include:
What is DME in diabetics?
DME is a complication of diabetic retinopathy that can lead to vision loss and blindness. Diabetic retinopathy is a common diabetes-related eye disease. It’s estimated to affect about 1 in 3 people with diabetes over the age of 40, per the National Institute of Diabetes and Digestive and Kidney Diseases.
Why do diabetics need a dilated eye exam?
People with diabetes should get a dilated eye exam every year to check for vision complications, according to the CDC. Diabetic macular edema (DME) is a complication of diabetic retinopathy, an eye disease related to diabetes. DME affects an estimated 750,000 people in the United States, according to the National Eye Institute.
How many people are affected by DME?
DME affects an estimated 750,000 people in the United States, according to the National Eye Institute. The condition is the leading cause of blindness among people with diabetic retinopathy. There’s no cure for DME, but treatment can stop or slow its progression. Read on to learn more about DME, treatment options and goals, ...
What is the procedure to remove a gel-like substance from the inside of the eye called?
In advanced cases of DME, surgery may be a treatment option. It involves a procedure called vitrectomy to remove a gel-like substance known as vitreous that fills the inside of the eye and can pull on the macula.
How to manage diabetes?
Other ways to help manage diabetes include: see your endocrinologist as recommended . take medications as advised.
Can diabetic macular edema be cured?
Can it be cured? Diabetic macular edema is a complication of diabetes that can cause blindness. There is no cure for diabetic macular edema, but treatment can help slow progression of the condition and prevent blindness. People with diabetes should get a dilated eye exam every year to check for vision complications, according to the CDC.
What causes diabetic macular edema?
In people with uncontrolled diabetes or fluctuating levels of blood sugar levels, the inner lining of the blood vessels is damaged.
2 types of diabetic macular edema
DME progresses over time in people who have diabetes. Risk factors that can increase the risk of DME in people with diabetes include
What are the symptoms of diabetic macular edema?
Diabetic macular edema (DME) doesn’t always cause symptoms in the early stages. A person with diabetes should have their eyes examined every year to help identify any signs of retinopathy or DME.
How is diabetic macular edema treated?
Treatment of diabetic macular edema (DME) aims at maintaining the vision of the patient and preventing future loss of vision.
How can diabetic macular edema be prevented?
Taking the following measures can help prevent diabetic macular edema (DME) and protect the vision.
Top What Is Diabetic Macular Edema (DME) Related Articles
Diabetes mellitus has become a worldwide epidemic, thanks to changing lifestyles and increasing obesity. Type 2 diabetes affects approximately 13% of the population of the United States. Worldwide prevalence of diabetes is estimated to be around 463 million people. Type 2 diabetes accounts for over 90% of patients with diabetes.
What is the treatment for CSME?
The standard of treatment for CSME since 1985 has been laser photocoagulation since the results of Early Treatment for Diabetic Retinopathy study (ETDRS) were published. In “focal” CSME, a focal laser pattern is used to treat leaking microaneurysms identified on the FA that contribute to the retinal edema. In “diffuse” CSME, intraretinal leakage is noted on the FA from dilated retinal capillary beds or intraretinal microvascular abnormalities (IRMA) without isolated, discrete foci of leakage. Macular grid is done for diffuse macular edema. Laser photocoagulation has been shown to decrease the risk of moderate visual loss from 24% to 12% by 3 years.
What is CSME in medical terms?
CSME is a clinical diagnosis and is defined bt the ETDRS (Early Treatment Diabetic Retinopathy Study) as: Retinal thickening within 500 µm of the macular center. Hard exudates within 500 µm of the macular center with adjacent retinal thickening. One or more disc diameters of retinal thickening, part of which is within one disc diameter of the macular center.
What is the risk factor for diabetic macular edema?
Chronic hyperglycemia is the major risk factor of diabetic macular edema. The incidence of DME over a 10 year period is 20% in patients with younger onset diabetes versus approximately 40% in older onset diabetes.
How long does acetonide release submicrograms?
It is supposed to release submicrogram levels of fluocinolone acetonide (FAc), for 36 months.
Is DME a neurovascular disease?
The exact pathogenesis of DME is still unclear. Recent evidence indicates that diabetic retinopathy (DR) is a neurovascular disease of the retina. Retinal neuronal abnormalities are present well before the retinal microvascular injury.
