DIABETIC MACULAR OEDEMA

What is Diabetic Macular Oedema?

Diabetic Macular Oedema is an accumulation of fluid causing swelling of the retinal tissues in the macula (central portion of the retina that controls our most detailed vision) due to leaking blood vessels. It is the most common manifestation of diabetic retinopathy and can lead to a reduction in visual clarity.

Who is at Risk of Diabetic Macular Oedema?

Everyone with type 1 or type 2 diabetes is at risk of developing Diabetic Macular Oedema, and the longer a patient has had diabetes the greater the chances of developing it.

Patients are at increased risk of Diabetic Macular Oedema if the blood sugars have been poorly controlled, or if there is untreated high blood pressure or lipid (cholesterol and triglycerides) levels. Other risk factors include renal dysfunction and pregnancy.

What is the Impact of Diabetic Macular Oedema?

If the swelling involves the centre of the macula there can be a reduction in vision but if the swelling has not yet involved the centre then a patient may be unaware of the problem.

How is Diabetic Macular Oedema Diagnosed?

Diabetic Macular Oedema may be suspected if there is a reduction in visual acuity. It is confirmed with a comprehensive dilated eye examination and Optical Coherence Tomography (OCT) scanning.

How is Diabetic Macular Oedema Treated?

Treatment options available for Diabetic Macular Oedema are:

Intravitreal Injection Therapy - If the central macula (fovea) is involved and the source of the leakage is close to the centre of the macula the injection treatment is the safest and most effective treatment modality. First-line therapy is with anti-VEGF medications such as Lucentis (ranibizumab) and Eylea (aflibercept). In cases that are more resistant to treatment steroid injections such as Triescence (triamcinolone) or Ozurdex (dexamethasone) may be required. It may be appropriate in cases where the areas of leakage are well away from the centre of the macula.
Vitrectomy - surgical removal of the clear, jelly-like substance (vitreous gel) that fills the inside of the eye may be required in select cases.

What if Diabetic Macular Oedema is Untreated?

Treatment may not be required if the swelling is not involving or threatening the centre of the macula. If there is long-standing swelling at the centre of the macula this can result in permanent reduction of vision due to damage to the retinal tissues.