Any stage of diabetic retinopathy may potentially be accompanied by diabetic macular edema. Swelling that is involving the central vision is treated with injections into the eye (intravitreal injections). Edema that is not involving the central vision, but is threatening the center vision may either be observed, treated with an in-office laser procedure, or be treated with an intravitreal injection. This a complex decision and a recommendation will be provided by a general ophthalmologist or retina specialist.
Diabetic macular edema can be divided into two categories: Center-involving and non-center-involving.
Non-center involving refers to patients in whom the edema is not located in the area of central vision. It therefore does not effect the patients vision. These patients may benefit from a gentle painless in-office laser procedure which decreases the risk by 50% of the swelling traveling from outside the area of central vision, and into the central vision.
How is diabetic macular edema treated?
Center-involving edema decreases the quality of the vision. The decreased vision may be as good as 20/20 or as bad as being unable to read any letters on the chart, despite the most updated glasses. Fortunately, there is excellent treatment for this condition which can be delivered in a painless treatment. Diabetic macular edema is typically treated with a class of medications called anti-vascular endothelial growth factors and possibly corticosteroids. These medications are very well tolerated with most patients gaining a substantial amount of vision. The average number of treatments for a patient receiving injections of anti-vascular endothelial growth factors is approximately 9 treatments in the first 12 months, 5 treatments in the second year, and 3 treatments in the third year. Patients receiving corticosteroids may potentially need less treatments, but still require frequent follow-up. Many patients will also require focal laser during their treatment for this condition.
Will my vision get better?
Nearly all patients experience a significant improvement in their vision with treatment. In general, The vision typically improves over a period of 4 months, and then levels off from there. This is certainly not true in all cases, especially if other causes of vision loss, such as cataract are present.
What can i do to optimize my vision?
It is critically important to optimize blood pressure and blood sugar. Missing appointments causes delays in treatments which tends to cause a decrease in vision and worsening edema. Following up and continuing treatment is very important.