Diabetic macular edema is the most common cause of vision loss among people with diabetes. Finding early treatment is essential to prevent severe vision loss.

Getting regular eye exams is the best thing you can do to protect your vision. There are few, if any, early warning signs of diabetic macular edema other than what can be observed via a dilated eye exam. (Learn More)

Treatment for diabetic macular edema begins with strict control of your blood sugar levels. Damage to the eye caused by macular edema can be corrected through a variety of approaches, including laser therapy, steroid intake, and medicines injected into the eye. (Learn More)

Treatment Options

The best treatment for diabetic macular edema is to manage diabetes since it is a vision condition that is the most common cause of vision loss in people with diabetes. The condition occurs when fluid builds up in the macula of the eye, which is at the center of the retina.

People with diabetes are at an increased risk of damage to their eyesight. The longer someone has diabetes, the more likely they are to experience vision loss. Small changes in blood sugar levels can increase the risk of developing diabetic retinopathy, followed by diabetic macular edema.

While the primary treatment is controlling the diabetes, other underlying conditions must be addressed as well as any damage that has been caused to the retina.

Damage caused by macular edema can be treated via:

  • Injection of anti-VEGF drugs to stop fluid from leaking from the blood vessels and slow the progress of macular edema.
  • Steroid pills, drops, or injections into the eye to reduce inflammation.
  • Laser therapy to seal leaking blood vessels.
  • Vitrectomy surgery to remove vitreous gel from the eye that is pulling on the macula.

No matter how your ophthalmologist recommends treating the damage caused by macular edema, it is important to remember that diabetes is a lifelong condition. Strict control of your blood sugar levels is essential for reducing the risk of many eye and vision problems, including diabetic retinopathy and macular edema.

Regular Vision Testing

Before you can treat diabetic macular edema, it must be diagnosed. This means a comprehensive eye exam from an eye doctor. They will be able to look for any abnormalities in the eye and specifically in the retina.

Additional tests, as explained by NEI, to assess the exact location and severity of the macular edema include:

  • Visual acuity test.
    A standardized chart or card is used to assess the vision in one eye at a time. You call out the smallest line of letters or objects that you can see.
  • The Amsler grid.
    The Amsler grid is an image to look at that helps to detect any changes to your central vision. If parts of the grid looks distorted, missing, or dark, you may have macular edema.
  • Dilated eye exam.
    Drops are placed in the eye to dilate the pupils and then an eye doctor can thoroughly examine the retina for any damage and disease.
  • Fluorescein angiogram.
    If previous tests indicate the presence of macular edema, eye doctors can do a fluorescein angiogram. In this test, special dye is injected into the arm and photos are taken of the retina as the dye move through your blood vessels. This helps assess the amount of damage done to the macula.
  • Optical coherence tomography.
    With the use of a special light and camera, this test provides a detailed view of the layers of the cells in the retina. It can be used before and after treatment for macular edema to assess the level of swelling in the retina.

The above tests can be used to determine the extent of damage caused by macular edema as well as other eye conditions. The information gathered via these tests can then be used to develop an effective treatment plan.

How Macular Edema Impacts Vision

The National Eye Institute (NEI) estimates that about 7.7 million Americans have diabetic retinopathy. Of those people, approximately 750,000 have diabetic macular edema. Diabetic macular edema can occur at any time in someone with diabetic retinopathy, though the risk of it happening increases over time.

As fluids build up in the macula and cause it to swell, vision becomes distorted. Macular edema is not typically painful and symptoms are often not noticeable when the condition first develops. Once the condition has progressed enough to notice it, the following symptoms are often experienced:

  • Blurry or wavy central vision
  • Colors that appear washed out
  • Difficulty reading

If left untreated, macular edema can have serious consequences on your vision. Severe vision loss and blindness can occur. For this reason, it is important to see an ophthalmologist as soon as you notice any vision symptoms, as you have already had the condition for some time by this point.

Risk Factors

People with diabetes are at an increased risk of damage to their eyesight. The longer someone has diabetes, the more likely they are to experience vision loss. Prior to macular edema, diabetic retinopathy occurs.

Diabetic retinopathy is a risk factor for diabetic macular edema. In the case of retinopathy, high blood sugar levels damage blood vessels in the retina. As damage occurs, the blood vessels swell and leak or close, and prevent blood from flowing through. Each of these scenarios can cause vision loss.

According to the Macular Society, nearly 90 percent of people with type 1 diabetes develop some level of retinopathy after 10 years. People with type 2 diabetes develop retinopathy after 10 years at a rate of 67 to 80 percent. Approximately 7 percent of people with diabetes go on to experience noticeable vision loss due to diabetic macular edema.

References

Diabetic Macular Oedma. Macular Society.

Macular Edema. (July 2019). National Eye Institute.

Macular Edema Symptoms. (October 2020). American Academy of Ophthalmology.

What Is Diabetic Retinopathy? (September 2020). American Academy of Ophthalmology.