Structure of the Eye
The Eye works in a similar way to a camera: the light goes through the lens and reaches the spool; In a similar way it happens in the eye: The light crosses the crystalline lens (the lenses of the eye) and reaches the retina. From The retina the image comes out through the optic nerve and reaches the brain by electrical signals.
The Central area of the retina is called a macula. This area is the most important for the central vision, the fine vision, to see well the details… Because with this part of the retina we can differentiate the colors, perform activities of close vision, reading, recognition of the faces… The rest of the retina is also important especially for the field of view and night vision. The space between the lens and the retina is filled with a gelatinous substance called vitreous.
How is diabetic macular edema produced?
In diabetic patients, over the years, the high blood sugar is causing little by little damage in the blood vessels of the organism (eyes, kidneys, foot…) In the case of the eye, it is affecting the circulation in the retina making its structure weaker and creating fluid leakage (edema). This can be seen clinically when performing an eye fund. The Retina Specialist Ophthalmologist puts a few drops to dilate the pupil and, through special examination lenses, can see the eye inside in a painless way and assess the injuries caused by diabetes.
As soon as the first lesions appear, we say that the patient has diabetic retinopathy. According To the observed severity, diabetic retinopathy is classified as: mild, moderate, severe and proliferative (from lower to greater involvement of the retina). When the circulation of the macula is particularly affected, accumulation of fluid appears in it causing diabetic macular edema.
Illustrations of the Eyeball
(Normal eye Fund)
(Eye Fund with lesions of severe diabetic retinopathy)
To assess whether the macula has liquid or it is not essential To perform an OCT (optical coherence tomography). The OCT is a very fast test (lasts a few seconds), painless and harmless, which is to perform a scan of the retina and macula inside. Through a laser technology, this test allows To see all layers of the macula inside and diagnose any alteration (either by diabetes or other causes). It is Also very important to monitor the response to the treatment and see the evolution of the patient.
OCT of healthy patient (above) and OCT of patient with diabetic macular edema (below)
ALL patients with some type of diabetic retinopathy may be accompanied by fluid (edema) in the macular area. The longer the duration of diabetes, if diabetes control is not good or if in addition to diabetes blood pressure and cholesterol levels are also elevated, there is A higher risk of developing diabetic macular edema.
What are the symptoms of diabetic macular edema?
In the early stages of the disease the patient may not notice anything and therefore it is important that diabetic patients periodically check a Retina specialist ophthalmologist.
As the disease progresses, diabetic macular edema causes decreased vision, distorted vision, blurred, and difficulty reading.
Treatment of Diabetic Macular edema
Control of blood sugar levels is very important for the control of the disease. When these symptoms appear in the eye it is important to work together with the endocrine or the family doctor. Since treatment should be intensified and the patient encouraged and supported to achieve good control of blood glucose levels.
gluQUO is a great help as an assistant for the management of diabetes: it will have in an organized way all its values of daily blood glucose as you will see the evolution of the glycosylated hemoglobin over time.
It is important that you become familiar with the concept of glycosylated hemoglobin; A parameter that is measured in a blood test and that indicates the glucose control that you have had in the last 3 months. It’S like a summary of how sugar values have been in the last 3 months and is more reliable than an isolated sugar measurement. Since in general, levels below 7 indicate good control of diabetes. If your level is greater than 8 (and above all more than 10) diabetes control is not good.
The treatment of diabetic macular edema consists of puncturing inside the eye…
There Are 2 families of drugs: antiangiogenic and Intravitreal corticoids. These drugs Decrease the edema (they make that fluid disappear in the retina), and also the antiangiogenic have a regression effect on the lesions of diabetic retinopathy (make them disappear gradually).
Your Retina Specialist Ophthalmologist will recommend the best treatment for you. Specifically, this type of injections are done with topical anesthesia (drops) and are not painful. The patient usually requires several injections during the first years of the disease. These medications have reduced blindness to diabetes in many cases so it is very important to go to the revisions and get treatment if indicated.
With the treatment it will not only stop losing vision but in general patients can gain vision in a meaningful way.