Speak to Your Doctor About These Options
Diabetic macular edema (DME) is a common complication of diabetic retinopathy, leading to swelling in the macula caused by leaky blood vessels in the retina. In this article we're looking at treatment options such as Eylea, an anti-VEGF drug used to treat types of macular edemas to improve vision.
1. Eylea (Aflibercept)
Eylea is a prescription medication that belongs to a class of drugs known as VEGF inhibitors. It works by blocking vascular endothelial growth factor (VEGF), a protein that promotes abnormal blood vessel growth and leakage in the retina.
It's administered via an intravitreal injection (injection into the eye), typically every four to eight weeks after an initial dose. It reduces swelling in the eye and helps stabilize or improve vision.
Clinical studies have shown that Eylea significantly improves eyesight in patients with DME. It is often chosen as a first-line treatment due to its strong efficacy and safety.
2. Lucentis (Ranibizumab)
Lucentis is another VEGF inhibitor, similar to Eylea, and is designed to target and reduce VEGF activity in the retina. It helps decrease fluid buildup in the eye.
It's delivered via monthly intravitreal injections. For some patients, the frequency may be reduced based on treatment response. Lucentis has proven effective in improving vision and reducing retinal thickness in patients with DME. Its dosing flexibility makes it a viable option for many individuals.
3. Ozurdex (Dexamethasone Implant)
Ozurdex is a corticosteroid implant used to treat DME. It's often used in patients who may not respond well to VEGF inhibitors.
It's a small biodegradable implant injected into the eye. It gradually releases dexamethasone, a steroid that reduces inflammation and suppresses vascular leakage. Ozurdex is particularly useful for patients with chronic or recurrent DME. While effective, it carries a higher risk of side effects such as increased intraocular pressure and cataracts, so regular monitoring is required.
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4. Iluvien (Fluocinolone Acetonide Implant)
Iluvien is a long-acting corticosteroid implant designed for patients with DME who have had an insufficient response to other treatments.
It's a tiny cylindrical implant injected into the eye, where it continuously releases fluocinolone acetonide for up to three years. Its long duration makes it a convenient option for many patients. This treatment options helps reduce inflammation and stabilize vision. However, like other steroid-based treatments, it may increase the risk of cataracts and glaucoma.
5. Photocoagulation (Laser Therapy)
Laser therapy is one of the oldest treatments for DME, though it is now less commonly used as a standalone therapy due to the discovery of VEGF inhibitors.
During photocoagulation, a laser is used to seal leaking blood vessels and reduce fluid buildup in the retina. Focal or grid patterns are applied depending on the location and extent of the edema. While laser therapy is not as effective in improving vision as VEGF inhibitors, it can help stabilize the condition and prevent further vision loss.
6. Vitrectomy
Vitrectomy is a surgical procedure recommended for cases of DME that involve severe vitreous hemorrhage or traction on the retina. During the procedure, the surgeon removes the vitreous gel and replaces it with a clear solution. This relieves traction on the retina and helps reduce macular swelling.
Vitrectomy is typically reserved for complex cases but can significantly improve retinal health and vision in such scenarios.
7. Dietary and Lifestyle Modifications
Though not a primary treatment, managing blood sugar levels through diet and lifestyle changes is essential for controlling DME.
Patients are advised to maintain tight control of their blood glucose, blood pressure and cholesterol levels. This can be achieved through a balanced diet, regular exercise and prescribed medications. While lifestyle modifications alone cannot reverse DME, they play a crucial role in preventing progression and enhancing the effectiveness of other treatments.
8. Investigational Treatments
Ongoing research is always being done to discover new therapies for DME, including novel drugs, gene therapies and advanced delivery systems.
Experimental treatments aim to address underlying causes of DME more effectively or reduce the frequency of injections required with current therapies. Though still under investigation, emerging therapies hold promise for improving outcomes and convenience for patients.
Final Notes
Diabetic macular edema is a serious complication of diabetes that requires timely intervention. Eylea, along with other VEGF inhibitors like Lucentis, remains a cornerstone of treatment, while corticosteroid implants and surgical options provide alternatives for specific cases. Lifestyle modifications and emerging therapies complement these, offering hope for better management and outcomes. If you or someone you know is living with DME, consult a retina specialist to discuss the most suitable treatment plan.