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Who Is At Risk for Diabetic Macular Edema?

diabetic macular edema

Diabetic macular edema is, as the name indicates, an eye condition and one that can have a serious impact on individuals who have diabetes. The authors of a new study have identified which segments of the diabetic population is more likely to be affected by this complication.

What is diabetic macular edema?
Type 1 diabetes and type 2 diabetes are associated with a variety of microvascular changes, and macular edema is one of the associated complications that can arise. Diabetic macular edema is a condition in which the blood vessels in the retina begin to leak into the macula, which is located near the center of the retina.

As the blood continues to leak into the macula, which is responsible for detailed central vision, the retina thickens and swells. Partial or even complete vision loss can be the result.

Diabetic macular edema study
The study was conducted by scientists at Keck Medicine of the University of Southern California, Los Angeles. It involved analysis of data from 1,038 individuals age 40 and older who had diabetes and adequate photographs of their eyes from the National Health and Nutrition Examination Survey. An evaluation of the data revealed the following:

  • 55 (3.8%) of the individuals in the study had diabetic macular edema
  • Significant risk factors for developing diabetic macular edema were shown to include having diabetes longer, having a higher level of hemoglobin A1c, and being non-Hispanic black
  • Age and sex did not appear to be a factor in the development of this vision problem

Treatment of diabetic macular edema
Currently, treatment for diabetic macular edema usually involves laser photocoagulation. In this procedure, clinicians use a laser to burn or cauterize the leaking blood vessels in the eye. Unfortunately, this treatment approach can result in partial loss of night or peripheral vision.

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In addition to laser treatment, some retinal specialists also include administer injections of corticosteroids or antivascular endothelial growth factor substances to help improve the outcome of treatment. Until recently, neither of these injections were approved by the Food and Drug Administration for this eye condition.

However, on July 29, 2014, the Food and Drug Administration approved the vascular endothelial growth factor inhibitor called aflibercept (Eylea by Regeneron) for treatment of visual problems caused by diabetic macular edema. Aflibercept was approved previously for two other vision conditions—wet age-related macular degeneration and macular edema after central retinal vein occlusion.

Treatment with aflibercept involves injections into the eye. The injections typically should be given once a month for five months followed by an injection every eight weeks.

Bottom line
The findings of the new study suggest that individuals who have diabetes should be vigilant about having eye examinations yearly or more often, especially if they are among those at higher risk for diabetic macular edema. Given that August is National Eye Exam Month, now is a great time to make an appointment.

Also read about diabetic retinopathy

Varma R et al. Prevalence, risk factors for diabetic macular edema explored in study. JAMA Ophthalmology Published online 14 August 2014
University of Southern California

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