About DME

Suggestive of its name, Diabetic Macular Edema (DME) is a disease linked to diabetes and occurs when fluid leaks into the centre of the retina at the back of the eye (called the macula) resulting it to swell.1 This affects one’s visual ability to read and see details clearly2,5,6,7 and is one of the most common causes of blindness.1,2,3

Statistically, over 50% of the people with DME are affected in both the eyes. But it may not affect the vision in both.8,9 Consult your doctor if you have DME in one eye and ask for prevention for the other eye.

While DME cannot be cured, the progression of vision loss can possibly be slowed down and the vision can be improved.2 There are also many ways for you to take part in your own healthcare, manage your diabetes and contribute to the health of your eye.

In a healthy retina20, the fovea (the centremost part of the macula) will appear divided.18

In DME, the blood vessels leak and the fluid collects in the retina and macula. This causes the macula to swell and bulge.18

Symptoms

 

In the early stages, you may not experience the symptoms of DME. However, over time, your eyesight will get worse and you may experience some vision loss. Hence, it is important that you get your eyes checked regularly.

Watch out for these common symptoms2:-

Wavy Vision

Black Spots

Blurry Vision

Risk Factors19

 

Some of the risk factors that predispose certain people to the development and progression of Diabetic Macular Edema (DME) include:

  • Degree of diabetic retinopathy
  • Duration of diabetes
  • Type of diabetes
  • Severe hypertension
  • Fluid retention
  • Hypoalbuminemia or low protein in body fluids
  • Hyperlipidemia or high fat levels in the blood

What Can I Do?

There are several things that you can do to prevent or delay vision loss.

Proactively monitor your vision

 

  • Visit your eye doctor/ eye specialist regularly (every 3 months) - do not miss any scheduled appointments.1,4,6,11
  • If you notice a change in your vision, contact your eye doctor/eye specialist immediately.2
  • Be proactive/ dedicated about vision rehabilitation and the use of visual aids [ex. using a magnifying glass].12
 

Take control of your diabetes

  • Take your diabetes medications as directed by your doctor6,7,10,11,13
  • Regularly monitor your blood sugar levels. Keeping your levels under control is the single most important way to manage your diabetes1,6,11,13
  • Keep blood pressure under control1,6,11,13
  • Maintain a healthy body weight and manage your diet. Your doctor can tell you what you should and shouldn’t eat as well as when you should eat.7,10,11,13
  • If you smoke, speak with your doctor about a termination program and work towards quitting as soon as you can7,10,11,13
  • Exercise regularly to help avoid high blood pressure and raised cholesterol10,11,13

You have an important role to play in controlling your diabetes, ensuring that vision loss is caught early and getting treated as soon as possible.1,2,6,11,13

References:

1. Ciulla TA, et al. Diabetic retinopathy and diabetic macular edema: pathophysiology, screening, and novel therapies. Diabetes Care. 2003;26:2653-2664.

2. National Eye Institute. Facts About Diabetic Eye Diseases. Available at: http://www.nei.nih-gov/health/diabetic/retinopathy.asp; Accessed on Mar 30, 2016.

3. Fareed A. A review of diabetic macular edema. Digital Journal of Ophthalmology. 1997;3[6].

4. Watkins PJ. Retinopathy. BMJ. 2003;326:924-926.

5. American Diabetes Association. Living with diabetes. 2011. Available at: http://www.diabetes.org/living-with-diabetes/cornplications/eye-complications/; Accessed on Mar 30, 2016.

6. Canadian Diabetes Association. Diabetes and you: vision health. 2011. Available at:  http://www.diabetes.ca/diabetesandyou/living/complications/vision-health/; Accessed on Mar 30, 2016.

7. Royal College of Ophthalmology. Diabetic Retinopathy Guidelines. 2012. Available at: http://www.rcophth.ac.uk/wp-content/uploads/2014/12/2013-SCI-301-FINAL-DR-GUIDELINES-DEC-2012-updated-July-2013.pdf; Accessed on Mar 30, 2016.

8. Varma R, et al. Visual Impairment and Blindness Avoided with Ranibizumab in Hispanic and Non-Hispanic Whites with Diabetic Macular Edema in the United States. Ophthalmology. 2015;122(5):982-989.

9. Revisiting DME. Available at http://www.retinalphysician.com/printarticle.aspx?articlelD=106441; Accessed on Mar 30, 2016.

10. Eyre H and Kahn R. Preventing cancer, cardiovascular disease, and diabetes. Diabetes Care. 2004;27:1812-1824.

11. National Diabetes Information Clearinghouse. Prevent diabetes problems: Keep your diabetes under control. 2008; NIH Publication No. 08-4349.

12. Mayo Clinic Staff. Lifestyle and home remedies. Available at: http://www.mayoclinic.org/diseases-conditions/wetmacular-degeneration/basics/lifestyle-home-remedies/con-20043518; Accessed on Mar 30. 2016.

13. WHO. Fact sheet 312: Diabetes. 2011. Available at: http://www.who.int/mediacentre/factsheets/fs312/en; Accessed on Mar 30, 2016.

14. The Amsler Grid. Available at http/www.amd.org/the-amsler-grid/; Accessed on Oct 05, 2017.

15. Crossland M, Rubin G; The Amsler chart: absence of evidence is not evidence of absence. Br J Ophthalmol.2007;91:391-393.

16. LUCENTIS® Summary of Product Characteristics. Novartis AG; Sept. 2015.

17. Hariprasad SM, et al. Vision-related quality of life in patients with diabetic macular edema. Br J Ophthalmol. 2008;92:89-92.

18. About DME. Available[online] at URL: https://www.lucentis.com/diabetic-macular-edema-information. As accessed on June 22, 2018.

19. Diabetic Macular Oedema. Available [online] at URL: https://www.vsp.com/diabetic-macular-edema.html. As accessed on June 22, 2018.

20. Anatomy of the eye. Available [online] at URL: https://www.moorfields.nhs.uk/content/anatomy-eye. As accessed on June 18, 2018.