DME is a condition in which fluid builds up in the macula, the center of your eye’s retina, according to the National Eye Institute (NEI). “This part of your retina is essential for reading, driving, and seeing people’s faces,” says Lee M. Jampol, MD, an ophthalmologist at Northwestern Memorial Hospital and the Louis Feinberg, MD, a professor of ophthalmology at Northwestern University Feinberg School of Medicine. Diabetes weakens the blood vessels throughout your body, including those in the eyes. “It’s like a leaky pipe that drips on ceiling tiles,” says Sunir Garg, MD, a retina specialist and clinical spokesperson for the American Academy of Ophthalmology. “Eventually the tiles will rot and fall apart.” Similarly, this fluid leakage in the eye causes the macula to become swollen, which can harm your vision. An ophthalmologist can detect DME via an eye exam. Left untreated, however, the condition can lead to temporary — and then permanent — loss of central vision, says Dr. Jampol. That’s why if you have diabetes, it’s essential that you get an eye exam at least annually. (Your doctor will let you know if you need to go in more often.) When it’s time to treat DME, here are a few options your doctor may discuss with you:
Injectable drugs
What they do Anti-VEGF injections are the gold standard treatment for DME, says Jampol, and work by slowing down blood vessel growth and stopping fluid leaks. (VEGF stands for vascular endothelial growth factor.)Who should use them Most people with DME will probably be treated with anti-VEGF injections, says Jampol. “As soon as they became available 10 or 12 years ago, it was clear they were the best treatment for DME,” he says.What to know about them You’ll receive numbing drops in your eye, and then the doctor will administer the injections via a thin needle. “Shots given into the eye sounds terrible, but they’re safe and easy to do, and result in minimal discomfort,” says Jampol. You’ll need about nine shots in the first 12 months, followed by four to five shots in the second year and one to two in the third. By years four to five, many people don’t require any, he says.
Steroids
What they do Available in eye drops, pills, or injections, steroids reduce inflammation in the eye, according to the NEI.Who should use them People who didn’t experience relief from anti-VEGF treatments.What to know about them While they’re very effective, says Dr. Garg, they come with side effects. They can speed up the growth of a cataract (a clouding of the lens of your eye), and they can also cause eye pressure to increase. That said, he points out that both of these side effects are treatable.
Lasers
What they do Lasers use heat to close leaking blood vessels.
Who should use them If you have only a few leaky spots in the macula, a laser can help “weld” them, says Garg. However, “the majority of patients have multiple leaky vessels in multiple small areas, making anti-VEGF treatments better,” he says.What to know about them Lasers were once the favored treatment, but anti-VEGF injections have become more the common type of therapy.
Taking the Important Step to Prevent Vision Loss From Diabetic Macular Edema
If you have diabetes, DME isn’t inevitable. You can prevent the disease by maintaining healthy blood sugar levels or taking medication. These steps can also slow the progression of the disease and prevent future damage. “We encourage patients to get their blood sugar and blood pressure under control,” says Garg. Lowering your A1c levels is an investment into your future health — and vision.
