What Is Diabetic Macular Edema?

Macular edema is a buildup of fluid in the macula. The macula is an important part of the retina, which is the inner lining of the eye. The macula gives us our detailed and central vision. Fluid buildup causes the macula to swell and thicken. This can distort and impair vision.^1,2

High blood sugar (glucose) can damage blood vessels in the retina (diabetic retinopathy). Tiny bulges can form in the vessel walls and leak fluid into the macula. This is a serious eye complication for people with diabetes. It is called diabetic macular edema (DME).¹

How common is diabetic macular edema?

The prevalence of DME among people with type 2 diabetes (T2D) varies by region. About 7.7 million people in the United States have diabetic retinopathy. About 750,000 of these people also have DME. The number of people with DME is increasing because more people have T2D.²

Diabetic retinopathy is a leading cause of permanent blindness in adult Americans. DME is the most common cause of vision loss in people with diabetic retinopathy. Black Americans are 3 times more likely to develop DME than white Americans.²

What are the symptoms of diabetic macular edema?

During the first stages of DME, you may not show any symptoms. Once it progresses, you may start to notice eye symptoms. Talk to your doctor if you notice any signs or symptoms of DME. These include:^2,3

• Blurry vision
• Changes in how you see color
• Vision loss

What are the complications of diabetic macular edema?

Untreated DME can lead to permanent damage to the macula. This can lead to:^2,4

• Vision loss
• Blindness
• Vitreomacular traction syndrome (when gel around the retina pulls on the macula)

How is diabetic macular edema treated?

The best strategy is to treat both the underlying cause (diabetes) and the macular edema. Treatments for diabetes can help reduce blood sugar levels. This can reduce the risk of DME getting worse.^2,4

Treatments for macular edema include:^2,4

• Anti-VEGF (vascular endothelial growth factor) injections – Drugs such as Avastin^® (bevacizumab), Eylea^® (aflibercept), and Lucentis^® (ranibizumab) block blood vessels in the eye from growing too much
• Corticosteroid eye drops or injections – Drugs that reduce inflammation in the eyes
• Corticosteroid implants – Drugs such as Ozurdex^® (dexamethasone), Retisert™ (fluocinolone acetonide), and Iluvien^® (fluocinolone acetonide) also reduce inflammation, but in an implant form that slowly releases medicine over time
• Focal laser photocoagulation – A procedure to seal leaking blood vessels
• Vitrectomy – Surgery to remove the vitreous gel in the center of the eye

Maintaining a healthy lifestyle is important for successful treatment. The right treatment depends on a number of factors, including:

• Your overall health
• How severe your DME is
• How well your blood sugar is controlled
• Personal preference

How is diabetic macular edema prevented?

The best way to prevent DME is to manage blood sugar and blood pressure. The risk of DME is higher when blood sugar levels are not controlled. Treatments that manage blood sugar reduce the risk and severity of eye complications. Changes you may want to make include regular exercise, a healthy diet, and T2D treatments.^2,4

If you have type 2 diabetes, you should have your eyes examined yearly or as often as your doctor recommends. The earlier you are diagnosed with DME, the better outcomes you are likely to have.⁵