Diabetic Macular Edema – Treatment

What are the treatment options for diabetic macular edema?
Treatment of diabetic edema is by either a laser or an injection inside eye or combination of both.
 
How is laser done for it?
Laser is usually done to close the leaking vessels causing macular edema. Sometimes 2 or 3 sessions of laser are required at an interval of 2-4 months. The laser is usually done by putting eye drops in eye. It is done sitting on the machine Laser photocoagulation is an outpatient procedure. You will be able to go home afterward.
 
What are possible complications / side effects?
Because laser photocoagulation involves tiny burns to seal the capillaries, small spots may appear in your field of vision after the procedure. These small spots generally fade and disappear with time. If your vision was blurry prior to the laser photocoagulation procedure, you may not completely recover clear vision.
 
What injections are to be given inside eye?
There are few injections that are given inside the eye. These include Ozurdex, triamcinolone, Lucentis and Avastin (Bevacizumab)The choice of drug depends on the condition of eye. The injections need to be given in an operating theater to minimize the risk of infection. They are given only by putting anesthetic drops. Usually no anesthetic injections are required. There may be minimal pain but is usually tolerable.
 
How do these injections these injections work?
These injections act on the leaking vessels in macula and reduce or stop their leakage. This leads to reduction in swelling in macular area which may lead to increase in vision. Avastinand Lucentisin addition rapidly closes the new blood vessels on retina giving a double advantage.
 
What are possible complications of the injection?
As with any injection, chances of infection inside eye are there. However, all due precautions are taken to minimize this complications. Triamcinolone may sometimes lead to increase in eye pressure in 2-3 months time. This can usually be controlled by eye drops; very rarely a surgery is required.
 
How much vision will I regain?
The aim of the laser treatment is to preserve and maintain the current level of vision. It is usually successful in preventing further visual loss. It is not intended to improve the vision. However, in some cases it may improve vision. Injection inside eye may improve vision in many cases, but not to the normal level.
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