Treating DME-Options Are Available

May 21, 2024

Individuals with diabetes might find their macula swells. This condition is known as diabetic macular edema or DME. They discover it is doing so when they develop blurred or double vision or notice dark spots in the eyes when looking at something.

Diabetic macular edema is typically treated in two ways. First, doctors must determine the cause of the problem and treat it. Once this has been done, they need to heal the retina. Often, this requires the patient to be seen by an ophthalmologist or retina specialist. They determine which treatment option is best for each patient.

Underlying Causes of DME

Before beginning a dme treatment program, a doctor must determine the root cause of the swelling. For some individuals, high blood sugar is to blame. Other men and women develop DME following an operation on the eyes, and those with macular degeneration need to be monitored for this condition. Blocked retinal veins, radiation treatments, and swelling in the uvea may also play a role in the development of DME. It may be a side effect of certain medications used to treat cancer, diabetes, and multiple sclerosis. Tackling the underlying cause will help doctors treat the patient. What treatment options might be suggested?

Anti-VEGF Shorts

Individuals with DME overproduce a protein known as VEGF. The first line of treatment for this condition is an anti-VEGF treatment. These medications slow the growth of blood vessels, as growing too quickly can lead to weak vessels that leak blood and fluid. The blood and fluid make their way into the macula and retina. Anti-VEGF shots block the protein. Doing so stabilizes the existing blood vessels while halting the growth of new ones.

Doctors might prescribe Eylea, Avastin, or Lucentis to treat patients with DME. However, they may also turn to Ang-2 inhibitors, such as Vabysmo, to control Angiopoietin-2 production in the body. This protein also plays a role in blood vessel formation, and these inhibitors stop new blood vessels from leaking by stabilizing them. In addition, the inhibitors reduce the blood vessels' sensitivity to the effects of VEGF. The VEGF/Ang-2 inhibitor most commonly prescribed today is Vabysmo.

Doctors place numbing drops in the eyes and inject the selected medication in the center of the eyes using a thin needle. Initially, most people get monthly shots. After the first four to six months of treatment, the frequency declines over several years. Vision improves when the blood vessels stop leaking.

Individuals with poor vision typically respond best to Eylea. However, Vabysmo treatments usually aren't needed as often because this medication inhibits both VEGF and Ang-2. Nevertheless, women who are pregnant cannot take the shots, as they may harm the baby, and some people don't respond well to this treatment. In addition, patients must be monitored for eye infections or inflammation.

Laser Surgery

Doctors might recommend focal-grid macular laser surgery for some patients today. This treatment seals blood vessels and slows the leaking of fluid and blood into the retina. However, the surgery results in microscopic scars. These scars may lead to mild loss of vision and reduced side vision. Some patients report their night vision has worsened along with their color vision. Blurred vision and difficulty focusing are also side effects that may be seen with laser surgery for DME. For these reasons and more, doctors no longer recommend focal-grid macular laser surgery as a first-line treatment for DME.

If this treatment must be used, the doctor treats each eye separately. Once the first eye is done, a few weeks will pass before the surgery on the second eye is performed. Most people only need one treatment per eye. For patients who don't respond fully to anti-VEGF shots, laser surgery may be recommended in conjunction with the shots.

Corticosteroids

Corticosteroids, more commonly referred to as steroids, target the inflammation seen with DME. These drugs help reduce swelling in the retina. Upon examining a patient, the doctor will determine whether to deliver the steroids through a shot or by placing a tiny implant in the patient's eye.

When the implant is selected, patients won't need to do anything. The implant slowly releases the medication and dissolves over time, so there is no need to return to the doctor and have it removed. Common corticosteroids used to treat DME include Ozurdex, Retisert, and Trivaris.

However, steroids aren't as successful in treating DME as anti-VEGF shots, so most doctors don't initially recommend this option. In addition, steroids come with other side effects. The person must be monitored for the development of glaucoma, cataracts, and other conditions.

NSAID Eye Drops

Non-steroidal anti-inflammatory drugs are used to battle inflammation, and a doctor might prescribe NSAID eye drops for patients who have just had eye surgery to prevent DME from developing. This is the preferred treatment option for these patients, as NSAIDs are similar to steroids in that they treat inflammation. However, they don't come with the same side effects. Some patients do experience headaches or floaters when NSAID eye drops are used. These drops cannot treat DME unless it is very mild. Common NSAID eye drops used for the treatment of DME and to prevent this condition from developing include Bromsite and Acular.

Vitrectomy

Vitrectomy is a surgery used to treat DME in some patients. Doctors believe that removing the transparent gel found in the back of the eye can stop the pulling force it exerts on the retina. This may help reduce the swelling seen with this condition and slow VEGF production. However, this treatment may also lead to the development of cataracts or glaucoma, and patients must be monitored for other side effects, such as retinal tears or infections.

Every person with diabetes must be monitored for this condition, as it is a leading cause of blindness in adults today. Up to ten percent of people with diabetes struggle with DME. Fortunately, treatments are available to slow or halt its progression. Every person should have annual eye checkups to catch problems such as these, as DME might be the first sign a person has diabetes. Make eye health a priority today, as your vision is too precious to be left to chance.

 

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