What is diabetic macular edema or DME?
Diabetic macular edema (DME) is a serious eye disease that can affect people with diabetes (1; 2). DME belongs to a group of diabetic eye diseases that can not only cause severe damage to your eyesight but are also the leading cause of blindness in working-aged adults (20–65 years) worldwide (3).
People with diabetes who have high blood sugar (glucose) levels over a long period of time are at risk of getting DME (1; 4). At the start, high levels of glucose damage small blood vessels in the retina, a light-sensitive tissue in the back of the eyes.
The damaged blood vessels start to bleed and leak fluids into the eye. The build-up of fluids causes swelling (known as edema) in an area of the retina called the macula. The swelling around the macula that results is known as diabetic macular edema, or DME.
Because the macula is responsible for sharp vision and seeing objects directly in front of you (known as central vision), swelling of this part of the eye can affect your ability to read or see faces clearly (2). Certain lifestyle and diabetes-related factors may increase your risk of developing DME (2; 5).
(Fig 1) DME is a disease affecting blood vessels in the back of the eye, which causes vision problems and blindness. The below pictures show the parts of the eye where damage occurs in DME
What are the risk factors for DME?
Although living with diabetes increases the risk of getting eye diseases, there are other causes (called risk factors) that can increase the risk of getting DME (5):
What are the symptoms of DME?
Symptoms of eye diseases may not be noticeable during the early stages of diabetes. However, as blood vessels start to leak and fluids build up over time in the macula, your vision can worsen dramatically (1).
Some of the main symptoms of DME affecting your eyesight are listed below (1; 2):
(Fig 2) Symptoms of DME can affect your vision in different ways. The below pictures show how the same image might be seen by a person with DME
How is DME diagnosed?
DME may be diagnosed during one of your regular eye screening visits, which should be a key part of your diabetes care. You will be given different exams by your doctor to test your vision (6; 7). Below are a few examples of possible eye tests:
(Fig 3) Two examples of the types of screening eye exams you may experience
If changes in your vision or retina have been found, your doctor will suggest follow-up tests (6). Two common tests that can give an even clearer picture of the retina and the severity of the changes in your eye are described below. Results from these tests help your eye care specialist to diagnose whether you have a diabetic eye disease and can help to find the most appropriate treatment (6; 7):
What treatment options are available for DME?
Once you have been diagnosed with DME, there are several available treatment options that can help to stop or reduce vision loss. In the first place, your doctor will aim to improve the control of your diabetes, including the below changes to your lifestyle (1):
Your physician will also suggest medical treatments to recover or stop vision loss, which can be used alone or together. These treatments include procedures directly involving the eye, such as injections and implants; however, your eye care specialist will ensure the procedures are painless by numbing your eyes with an anaesthetic first (6)
(Fig 4) Treatment options for DME include anti-VEGF injections, steroids (implant), and laser
If you have diabetes, it is important to attend regular screening sessions to test your eyesight and maintain a healthy lifestyle.