• Diabetes macular edema is a complication of diabetes that can cause blindness.
  • There’s no cure for diabetes macular edema, but treatment can help slow its progression and prevent blindness.
  • People with diabetes should get a dilated eye exam every year to check for vision complications, according to the Centers for Disease Control and Prevention (CDC).

Diabetes macular edema (DME) treatment does not lead to a cure, but it can often stop or slow its progression.

DME is a complication of diabetes retinopathy, an eye disease related to diabetes.

It affects an estimated 27 million people worldwide and is the leading cause of blindness among people with diabetes retinopathy.

Read on to learn more about DME, treatment options and goals, and the steps you can take to protect your vision.

DME is a complication of diabetes retinopathy that can lead to vision loss and blindness.

Diabetes retinopathy is a common diabetes-related eye disease. It’s estimated to affect about 1 in 3 people with diabetes over 40 years old, according to the National Institute of Diabetes and Digestive and Kidney Diseases.

Diabetes retinopathy happens when chronically high blood sugar levels damage the small blood vessels throughout your body, including your eyes.

Once they’re damaged, blood vessels can start leaking blood and other fluids. A part of your eye called the retina can absorb some excess fluid.

But when there’s too much fluid, you can experience swelling and thickening of the macula, an area in the center of the retina that helps you see clearly and precisely.

You may not have any symptoms of DME at first. But over time, DME can cause symptoms like:

  • blurry or wavy vision near the center of your field of vision
  • double vision
  • faded, less vibrant colors
  • floaters and blind spots
  • partial or total vision loss

The longer you live with diabetes, the more likely you are to develop diabetes retinopathy or DME.

There’s no cure for DME, but scientists are looking for potential ways to reverse vision damage from the condition or prevent it from occurring.

Research suggests that potential therapies for the DME precursor diabetic retinopathy can arise from targeting micro-RNAs, which are molecules that can regulate certain genes. Evidence suggests that altered expression of micro-RNAs occurs during diabetic retinopathy development.

In the meantime, DME treatments and diabetes management strategies can help stop or slow its progression.

The goal of treatment is to prevent further vision loss or blindness. In some cases, treatment can lead to vision improvements for people with DME, but it usually doesn’t fully restore sight.

If DME hasn’t made a noticeable impact on your vision, you may not need treatment right away.

However, your eye doctor will likely want to keep a close watch on potential signs that the condition is worsening, so you may need to get frequent vision checkups.

DME treatment typically starts once your vision worsens to prevent permanent damage.

Your DME treatment options depend on the severity of your vision loss. Sometimes, an eye doctor called an ophthalmologist will recommend a combination of therapies.

Here are the treatment options for DME:

The main treatment for DME is anti-VEGF injections into the eye.

These injections stop the activity of vascular endothelial growth factor (VEGF), which promotes the growth of blood vessels. This can reduce leakage from damaged blood vessels and slow the progression of DME.

Anti-VEGF drugs include:

Anti-VEGF therapy is usually a quick procedure that takes place in a doctor’s office. You’re given numbing drops to prevent you from feeling the needle. You may need to get a series of anti-VEGF injections over time to maintain your vision.

Anti-VEGF injections don’t work for everyone. Around half of those who try this treatment don’t see improvements. A 2023 study notes the following response rates:

  • 23% for best corrected visual acuity
  • 52% for central macular thickness

Corticosteroids are also a form of DME treatment. They work by reducing inflammation and swelling. They come as drops, tablets, or injections in or around the eye.

There are also three sustained-release corticosteroid implants approved to treat DME:

  • dexamethasone (Ozurdex)
  • fluocinolone (Retisert)
  • fluocinolone acetonide (Iluvien)

When corticosteroids don’t work or aren’t well tolerated, your doctor may recommend trying eye drops of nonsteroidal anti-inflammatory drugs (NSAIDs).

Laser therapy uses tiny laser pulses to seal off leaky blood vessels. This can also keep new abnormal blood vessels from growing.

Laser therapy can be performed in a doctor’s office. You’ll be given anesthetic eye drops to make it a painless procedure. Your doctor will use special instruments to hold your eye open and keep your head from moving while they focus the beam of light on the damaged areas.

If you have macular edema in both eyes, your doctor will likely treat each eye in separate appointments. Each eye may require several laser therapy appointments depending on the extent of the damage to the macula.

Laser therapy can lower the risk of vision loss due to DME.

While laser therapy used to be the standard therapy for DME, most doctors are now relying on anti-VEGF injections instead.

In advanced cases of DME, surgery may be an effective treatment option. It involves a procedure called vitrectomy, which removes a gel-like substance known as vitreous that fills the inside of the eye and can pull on the macula.

Once the surgeon removes the vitreous, they replace it with another substance, such as a saline solution.

Vitrectomy may raise the risk of cataracts, and you can develop DME again after surgery.

Understanding the risk factors for DME can help you take steps to prevent it. These include:

  • high blood sugar over a long period of time
  • high levels of fat in the blood (hyperlipidemia)
  • high blood pressure

Keeping a close watch on these conditions and taking steps to manage your diabetes can help improve your symptoms and eye health. Other ways to help manage diabetes include:

  • visiting your endocrinologist as recommended
  • taking medications as advised
  • getting a comprehensive eye screening every year (or more frequently if your doctor recommends it)
  • reporting new or worsening symptoms to your doctor
  • maintaining a moderate weight for your body type and size, as recommended by your doctor or another healthcare professional
  • eating a nutrient-dense diet
  • getting regular physical activity
  • avoiding or limiting alcohol consumption
  • avoiding smoking

DME is a complication of diabetes retinopathy caused by long-term damage to blood vessels in the retina.

There’s no cure, but treatments can manage DME. Several treatments can help slow its progression and prevent partial or complete vision loss.

Scientists are looking into the possibility of curing or preventing DME with micro-RNAs, but more research is needed.

If you notice any symptoms of DME, such as blurry or wavy vision or colors that look less vibrant than usual, speak with an eye care professional right away.