Diabetic macular edema (DME) can be cured by tackling the underlying medical cause and treating abnormal eye changes caused by the condition. The treatment of DME is more successful when it’s done in the early stages of the disease. Managing high blood sugar or blood pressure can prevent eye damage or keep it from worsening. After controlling high blood sugar or high blood pressure, consult an ophthalmologist or a retina specialist for treatment.
Currently, a new treatment available to cure DME has more favorable results than ever before. Additionally, more promising therapies will be available in the future.
What are the current treatments for diabetic macular edema?
The treatment goals of diabetic macular edema (DME) include
- Treating and controlling diabetes
- Controlling excess fluid leakage from the abnormal blood vessels in and around the macula (an oval light-sensitive area near the center of the retina)
Some of the current treatment options include
Laser therapy: Focal laser treatment remains an important treatment to reduce swelling of the macula—the part of the eye responsible for detailed, central vision. In laser therapy, the doctor applies many tiny laser pulses to areas with fluid-leakage around the macula. The main aim of this treatment is to seal the leaking blood vessels that interfere with the proper functioning of the macula.
Anti-inflammatory treatments: Corticosteroid pills, eye drops or injections are usually administered to treat DME. The three U.S. Food and Drug Administration (FDA)-approved corticosteroids for the treatment of DME are
- Ozurdex (extended-release dose of dexamethasone)
- Retisert (extended-release dose of fluocinolone acetonide)
- Iluvien (releases small doses of fluocinolone acetonide over the course of several years)
Nonsteroidal anti-inflammatory drug (NSAID) eye drops are used when steroids seem ineffective or the side effects of steroids are overwhelming.
Vitrectomy: Vitrectomy is preferred when other treatment options are unsuccessful. It is a procedure that removes the vitreous gel (gel-like substance in the eye) to relieve pulling on the macula. Vitrectomy also corrects vision and removes blood pooled inside the vitreous.
Anti-vascular endothelial growth factor (VEGF) injections: Medications block the activity of VEGF, which is responsible for the promotion of blood vessel growth. As a result, the progression of DME is delayed. Thus, anti-VEGF drugs block vessel formation and prevent leakage in the retina. The current standard of care is to administer intravitreal injections. During this procedure
- The physician applies numbing eye drops to the eye.
- They use a short, thin needle to inject medications into the vitreous gel.
Anti-VEGF drugs include
- Ranibizumab
- Bevacizumab
- Aflibercept
However, anti-VEGF drugs don’t work for everyone. Hence, you need to talk to a physician as to which option would suit you best.
What are the limitations of diabetic macular edema treatment?
Individual diabetic macular edema (DME) treatment has its limitations, which include
- Laser therapy: The limitations of laser therapy include
- Scarring
- Scotoma (partial loss of vision or blind spots)
- Impaired central vision in centrally involved DME
- Anti-vascular endothelial growth factor (VEGF) therapy: The limitations of anti-VEGF therapy include
- Repeated injections for optimal results
- Not all people respond to anti-VEGF therapy
- Steroid therapy: The limitations of steroid therapy include
- Risk of cataract
- Elevated intraocular pressure (fluid pressure inside the eye)
What are the emerging therapies for diabetic macular edema?
Several new drugs are under investigation for their effectiveness against diabetic macular edema (DME), including
- Rapamycin
- Everolimus
- Vatalanib
- Pazopanib
- Tetracycline
- Minocycline
The safety and efficacy of these drugs are yet to be established in the case of DME.
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