Diabetic macular edema: the strategy for monitoring it in people who still have good vision

An image of an eye to illustrate the concept of Diabetic macular edema and vision
© iStock/bombuscreative

A new study has been published on the strategy for monitoring diabetic macular edema.

The research, published in the Journal of the American Medical Association. The study found that people with diabetic macular edema, who still have good vision measured with an eye chart exam, can safely forego immediate treatment of their macular edema as long as they are closely monitored, and treatment begins promptly if vision worsens.

What is diabetic macular edema?

According to the Joslin Diabetes Center, Diabetic macular edema is the most common cause of vision loss among people with diabetic eye disease in the United States.

Diabetes can sometimes cause the development of leaky blood vessels in the retina at the back of the eye. It is caused by fluid build-up in the central area of the retina, called the macula. The macula is important for sharp vision.

The study

The study’s lead investigator Carl W. Baker, M.D., an ophthalmologist at Paducah (Kentucky) Retinal Center, said: “We now know that in patients with good vision and diabetic macular edema, similar to those enrolled in this trial, it’s an acceptable strategy to closely monitor patients, and initiate treatment only if their vision starts to show signs of decline.”

DRCR Retina Network Co-Chair, Jennifer K. Sun, M.D., M.P.H., associate professor of ophthalmology, Joslin Diabetes Center, Harvard Medical School, added: “Based on what we’ve seen in previous, longer-term studies of people with diabetic macular edema, the visual acuity outcomes observed at the end of this two-year study are likely to be maintained if patients continue regular follow-up and treatment as needed over subsequent years.”

The future of identifying diabetic macular edema

The director of the study’s coordinating center, Adam R. Glassman, MS, Jaeb Center for Health Research in Tampa, concluded: “Future technology may do a better job of identifying who might benefit from early treatment, before diabetic macular edema affects vision. But for now, close monitoring of diabetic macular edema in patients with good vision is an appropriate initial strategy as long as they are closely followed and subsequently treated if vision worsens.”

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