Diabetic Macular Edema
Diabetic macular edema (DME) is a complication of diabetes that affects the eyes. It affects 1 in 15 people with diabetes, resulting in more than 20 million cases worldwide. Both type 1 and type 2 diabetes can lead to DME, which may develop gradually.
Types of DME –
There are two main types of DME –
• Focal DME is small spots of fluid leaking.
• Diffuse DME has leaks and swelling throughout your macula.
In the early stages, this swelling may cause no symptoms. The location of the swelling, or edema, in the retina determines when the symptoms develop.
If the edema begins outside the central area of the retina, a person usually has no symptoms. As it spreads toward the center, a person may experience:
• blurred or wavy central vision
• colors that seem washed out or different
• difficulty reading
• Over time, high blood sugar levels can damage small blood vessels in the eyes, increasing the risk of DME.
• High blood pressure and high cholesterol levels can also contribute to blood vessel damage.
• In some cases of diabetes, pregnancy can increase the risk of developing DME. Your doctor may recommend more frequent eye exams during pregnancy.
For people with type 1 or type 2 diabetes, there are additional risk factors that can lead to DME. These risk factors includes –
• poor blood sugar management
• high cholesterol
• high blood pressure
• kidney disease (nephropathy)
• sleep apnea
To diagnose diabetic macular edema, your eye doctor will likely first perform a comprehensive vision exam.
Your doctor might also perform or suggest the following tests:
• Optical Coherence Tomography (OCT)
• Fluorescein Angiography
• Visual Acuity Test
• Amsler Grid
Treatments for diabetic macular edema will depend on your overall health such as how severe is the condition and many more.
Some medicines used to treat diabetic macular edema include –
• Anti-Vascular Endothelial Growth Factor (Anti-VEGF) Drugs
These medicines are given as an injection into the eye. They block the development of new, abnormal blood vessels and help control leakage from damaged blood vessels. Typically, several injections are needed.
Steroids can reduce inflammation in the eye. They’re usually given as an injection.
▪︎ Laser Treatment
A procedure called focal laser is used to seal up leaking blood vessels. It can slow or stop the growth of new blood vessels that could cause damage. The goal of this laser is to protect the vision you have and prevent future vision loss
Your doctor may recommend surgery if your condition is caused by vitreous (the gel-like fluid that fills your eye) pulling on the macula.
Ayurvedic Perspective –
According to Ayurveda, all three doshas, i.e., Vata, Pitta, and Kapha, are vitiated in macular edema.The fraction of Pitta concerned with eye is Alochaka pitta and the fraction of Kapha concerned with the eye is Tharpaka kapha. So, any factor which vititates the Alochaka pitta and Tharpaka kapha are capable of developing Macular Edema in the eye. The macular edema Ayurvedic treatment focuses on the rectification of this vitiation. A correction of the vitiation, correcting the underlying root cause, and rejuvenating Ayurvedic edema medicines help heal the retina’s leaking blood vessels.
▪︎ Steps of treatment
The treatment is conducted in two steps. First, the treatment is aimed to maintain the circulation in the retina of the eye so that the possibility of accumulation of fluid is eliminated. For this, treatment procedures such as sirodhara, udhwarthanam, etc. are preferable with appropriate medicines.
In the next step, the retina is strengthened so that functional capacity of retina is revived or increased. Ayurveda therapies like Thakradhara, Netradhara, Shirovirechan, Pindi, Vidalak, and Tharpana, can prevent macular edema are highly beneficial.
To prevent diabetic macular edema following steps could be taken –
• Maintaining good blood sugar control
• Keeping blood pressure and cholesterol levels in check
• Receiving a comprehensive eye exam at least once a year
• Following a healthy lifestyle that includes regular exercise and a nutritious diet
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