Diabetes is a leading cause of vision loss, and one of its most serious complications is diabetic macular edema (DME). This condition affects up to 10% of people with diabetes and can lead to significant visual impairment. Macular and retinal edema involve fluid accumulation in parts of the retina and are major causes of vision problems if left untreated.
What Are Macular and Retinal Edema?
Macular edema occurs when fluid builds up in the macula, the small central area of the retina responsible for sharp vision. This swelling can affect the fovea, the very center of the macula, making it hard to see fine details.
Retinal edema is a broader term that describes fluid accumulation anywhere in the retina. While macular edema directly impacts central vision, retinal edema can also affect peripheral sight, depending on where the swelling occurs. Macular edema is a specific type of retinal edema.
Causes and Risk Factors
In people with diabetes, long-term high blood sugar levels can damage small blood vessels in the retina. This damage leads to diabetic retinopathy, which causes blood vessels to leak fluid into the retina. When the leakage affects the macula, it results in DME.
Other risk factors include poorly controlled blood glucose, high blood pressure, kidney disease, and high levels of fat in the blood. The longer a person has diabetes, the higher their risk of developing DME. Nearly all people with type 1 diabetes and a significant portion with type 2 diabetes will show signs of diabetic retinopathy over time. Pregnancy also increases the risk, particularly for women with pre-existing diabetes.
Recognizing the Symptoms
Symptoms of macular edema may appear gradually. Common signs include blurred or distorted vision, double vision, and a sudden increase in floaters. Some people may struggle to focus clearly, especially when reading or driving.
Since vision changes can develop slowly, regular eye exams are crucial. Early detection allows for timely treatment and better outcomes.
Diagnosis and Monitoring
Eye specialists use advanced imaging techniques to diagnose and track macular and retinal edema. Optical coherence tomography (OCT) provides detailed images of the retina and shows the extent of swelling. Fluorescein angiography helps detect areas of leakage by using a special dye.
People with diabetes should have a comprehensive dilated eye exam at least once a year. If edema or other changes are detected, more frequent monitoring may be needed.
Treatment Options
The most common treatment involves anti-VEGF medications, which are injected into the eye. These drugs help block abnormal blood vessel growth and reduce leakage. Treatment typically requires multiple injections over time.
Focal laser therapy is another option. It uses light to seal leaking blood vessels, slowing vision loss and sometimes improving vision. While this may create blind spots, it helps preserve remaining sight.
Managing diabetes is essential alongside any treatment. Good control of blood sugar, blood pressure, and cholesterol supports healing and prevents further damage.
Prevention and Long-Term Eye Health
Prevention starts with healthy living. Maintaining stable blood sugar, exercising regularly, and eating a balanced diet can protect the eyes. Smoking cessation and stress management also contribute to better outcomes.
Routine eye care is key. Annual exams help detect problems early, and pregnant women with diabetes should be checked as soon as possible. Additional follow-ups during pregnancy may be needed to prevent complications.
