January 26, 2014

Eye Disease – Diabetic Macular Edema

It is interesting reading some of the topics at DiaTribe dot Com. Diabetic macular edema (DME) is a form of diabetic retinopathy. This happens when high blood glucose levels cause blood leakage in the small blood vessels and the resulting swelling of the macula can cause blurry vision.

Diabetic macular edema affects people with type 1 and type 2 diabetes. About 75,000 new cases of DME develop each year. This makes DME the leading cause of blindness in working-age Americans. If people with diabetes would manage their blood glucose levels and have an annual dilated eye exam, there are several treatment options available to help prevent or delay DME.

In the past 25 years, the standard for treating DME has been laser surgery. This seals up the leaking blood vessels to reduce the fluid around the macula. This procedure can stop the progression of vision loss, but cannot reverse the damage that has already been done.

Today, we have an alternative. The FDA approved in August 2012 a drug named Lucentis (ranibizumab), as the first drug for treatment of diabetic macular edema. Lucentis is a once monthly microinjection into the eye. Clinical trials show that in two years, individuals are able to read two additional lines on average on the eye chart. This is a great improvement and Lucentis is generally safe and well tolerated. Laser surgery and Lucentis are sometimes used in parallel to maximize outcome.

I will mention that Avastin, a drug approved for cancer treatment, is sometimes used “off-label” to treat DME if Lucentis is not available. It is a similar drug to Lucentis, but has not been approved for treatment of DME.

As a last resort, steroids are used “off-label” to treat DME. Steroids can cause additional cataracts and glaucoma.

Additional information can be read here and here. I feel they are worth the time reading if you have concerns in this area.

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