Diabetic Macular Edema

What is Diabetic Macular Edema

 Macular edema is defined as an abnormal macular thickening and excess fluid in the extracellular space of the retina. It is considered the leading cause of vision loss in the developed world in the working age population.

Current trends in the treatment of Diabetic Macular Edema

The Diabetic Retinopathy Clinical Research Network study in the USA, investigated ranibizumab (Lucentis) vs. Triamcinolone (an steroid) with laser treatment (Prompt versus deferred) and laser alone. It showed that the patients treated with ranibizumab had superior visual acuity results compared with the other groups.

Another randomized clinical study was the RIDE / RISE study (USA and Europe), comparing two different doses of ranibizumab versus a sham treatment for diabetic macular edema. Those with the ranibizumab gained on average 12 letters of visual acuity versus only four letters in the sham treatment group.

Also these studies demonstrated that the eyes that were treated with anti- VEGF agents as ranibizumab were more likely to have an improvement in their Diabetic Retinopathy Severity Scale and reduced the risk of Proliferative Diabetic Retinopathy (PDR) or the the end stage of diabetic retinopathy.

The eyes that received ranibizumab, less than 15% progressed to PDR at 3 years compared to 40% in the sham study eyes, significantly reduced the risk of severe vision loss.

In the United Kingdom, the BOLT study involved 80 eyes using bevacizumab or Avastin, an off-label treatment originally approved in the USA for colon rectal cancer and breast cancer. It showed that bevacizumab was superior to laser treatment.

Also the VIVID and Vista studies evaluated aflibercept or Eylea versus laser treatment. It showed that eyes that received Eylea gained on average 10 letters of visual acuity versus only one letter in the laser treatment group

What is the Newest Treatment for Diabetic Macular Edema?

In conclusion, the most recent data suggest that anti vascular endothelial growth factor agents previously discussed are becoming the first-line of treatment for macular edema and if the patient does not respond to these then we can add or combine them with laser treatment and steroids.

 Where To Get Treatment For Diabetic Macular Edema

All these agents are available at Sarasota Retina Institute and are performed routinely by Dr. Torres. If you have been diagnosed with diabetes, it is important to have at least a yearly exam of the retina to appropriately rule out, diagnosed and/ or treat diabetic retinopathy by a vitreo-retinal specialist.

Dr. Waldemar Torres, is a board certified and fellowship trained vitreo-retinal surgeon / sub- specialist that is available for the diagnosis and treatment of vitreo-retinal diseases such as diabetic retinopathy, age related macular degeneration, retinal detachment and acquired and congenital conditions. Call 941-921-5335  to schedule an appointment.

 

Waldemar Torres, MD 

Vitreo-retinal Surgeon

Sarasota Retina Institute

Sarasota, Florida

 

 

Jody Abrams, MD, FACS
Oculoplastics/Neuro-ophthalmology
Sarasota Retina Institute
Sarasota, Florida 34239

Comments

  1. sevlani nilesh m says:

    sir, i am from india sir, my mom have problem of retina. but no any solution of this type of dices. i get help from you sir. sir i have some photo and detial sent to you. sir which way i sent to the repot of this photo and file. sir please help me. god….help to you. sir reply is so so important.

    • Jody Abrams, M.D. says:

      please let me know what the disease is and I can give you a better idea of what could be done.

      Thanks
      Jody Abrams, MD

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