Treatment18,25

It is important to follow up on your diagnosis with a treatment as soon as possible,6,7 as the speed at which these eye diseases progress is dependent on a variety of factors that can be hard to control.

If one of your eyes is affected, the risk of developing it in your other eye goes up significantly.4,7,12 It is important to check your sight in both eyes regularly with tests like the Amsler grid.5,7,9,12

Although these are chronic diseases, current treatment options, such as anti-VEGF therapy, make it possible to delay, stop or reverse your vision loss and preserve your sight for longer, helping you to continue the activities you enjoy.7

Today, there are several treatment options open to patients with these eye diseases.3,6,7,9,10,12,20 You and your doctor will together determine which treatment is best for you.9

 

Management Through Lifestyle Changes18,25

The following lifestyle changes can help:

  • Exercise regularly

  • Diet Modification

  • Avoid smoking

  • Strict control of diabetes, hypertension, and hypercholesterolemia

Vitamins And Minerals19

 

  • Vitamins and minerals are considered essential nutrients-because acting in concert, they perform hundreds of roles in the body
  • Your eyes are complex organs that need many different vitamins and nutrients to function properly
 

Intravitreal Injections18,25

  • Medicines known as anti-Vascular Endothelial Growth Factor (anti-VEGF) or corticosteroids are injected in the eyes
  • Multiple injections may be required

Anti VEGF Therapy19

 

  • Anti VEGF stands for "anti-vascular endothelial growth factor"
    • VEGF is a protein that promotes blood vessel growth
  • Anti VEGF injection reduces new blood vessel growth and slows down any leakage or swelling these new blood vessels may cause
 

Administration Of Anti-VEGF Injection18,25

  • Anti-VEGF drugs are given as an injection into the vitreous (the jelly-like substance inside eye)
  • The injection is given through the white of eye (the sclera) under aseptic precautions and may be given in an operating theatre
  • The needle used for the injection is small and short and the injection itself is risk-free and only takes a few seconds

Submacular Surgery22,23

 

  • Abnormal blood vessels, scar tissue, or blood is removed

Retinal Dislocation22,23

  • Abnormal blood vessels that are directly under the centre of macula are destroyed
  • Macula is rotated away from the abnormal blood vessels
 

Laser Treatment18,23,25

  • Involves aiming an intense “hot” laser at the abnormal blood vessels in the eyes to destroy them

  • May also destroy some surrounding healthy tissue resulting in a small blind spot

Combined Therapy25

 

  • In some cases combination therapy is preferred
  • Laser + intravitreal injections
 

Low Vision Aids22

  • Low vision devices are designed to improve visual performance in people with low vision thus enabling daily routine activities with enriching experiences
  • They can be optical or optical and electronic
 

References:

1. Ciulla TA, et al. Diabetic retinopathy and diabetic macular edema: pathophysiology, screening, and novel therapies. Diabetes Care. 2003;26:2653-2664.

2. National Eye Institute. Facts About Diabetic Eye Diseases. Available at: http://www.nei.nih-gov/health/diabetic/retinopathy.asp; Accessed on Mar 30, 2016.

3. Fareed A. A review of diabetic macular edema. Digital Journal of Ophthalmology. 1997;3[6].

4. Watkins PJ. Retinopathy. BMJ. 2003;326:924-926.

5. American Diabetes Association. Living with diabetes. 2011. Available at: http://www.diabetes.org/living-with-diabetes/cornplications/eye-complications/; Accessed on Mar 30, 2016.

6. Canadian Diabetes Association. Diabetes and you: vision health. 2011. Available at: http://www.diabetes.ca/diabetesandyou/living/complications/vision-health/; Accessed on Mar 30, 2016.

7. Royal College of Ophthalmology. Diabetic Retinopathy Guidelines. 2012. Available at: http://www.rcophth.ac.uk/wp-content/uploads/2014/12/2013-SCI-301-FINAL-DR-GUIDELINES-DEC-2012-updated-July-2013.pdf; Accessed on Mar 30, 2016.

8. Varma R, et al. Visual Impairment and Blindness Avoided with Ranibizumab in Hispanic and Non-Hispanic Whites with Diabetic Macular Edema in the United States. Ophthalmology. 2015;122(5):982-989.

9. Revisiting DME. Available at http://www.retinalphysician.com/printarticle.aspx?articlelD=106441; Accessed on Mar 30, 2016.

10. Eyre H and Kahn R. Preventing cancer, cardiovascular disease, and diabetes. Diabetes Care. 2004;27:1812-1824.

11. National Diabetes Information Clearinghouse. Prevent diabetes problems: Keep your diabetes under control. 2008; NIH Publication No. 08-4349.

12. Mayo Clinic Staff. Lifestyle and home remedies. Available at: http://www.mayoclinic.org/diseases-conditions/wetmacular-degeneration/basics/lifestyle-home-remedies/con-20043518; Accessed on Mar 30. 2016.

13. WHO. Fact sheet 312: Diabetes. 2011. Available at: http://www.who.int/mediacentre/factsheets/fs312/en; Accessed on Mar 30, 2016.

14. The Amsler Grid. Available at http/www.amd.org/the-amsler-grid/; Accessed on Oct 05, 2017.

15. Crossland M, Rubin G; The Amsler chart: absence of evidence is not evidence of absence. Br J Ophthalmol.2007;91:391-393.

16. LUCENTIS® Summary of Product Characteristics. Novartis AG; Sept. 2015.

17. Hariprasad SM, et al. Vision-related quality of life in patients with diabetic macular edema. Br J Ophthalmol. 2008;92:89-92.

18. Facts About Age-Related Macular Degeneration. Available[online] at URL: https://nei.nih.gov/health/maculardegen/armd_facts. As accessed on June 19, 2018. 2.

19. Macular Degeneration. Available [online] at URL: http://www.northtexasretina.com/macular-degeneration.htm. As accessed on June 19, 2018.

20. Age related macular degeneration. Available [online] at URL: http://rgw.com/patient-education/eye-diseases/age-related-macular-degeneration. As accessed on June 19, 2018.

21. Macular Degeneration. Available[online] at URL: https://patient.info/health/visual-problems/age-related-macular-degeneration. As accessed on June 19, 2018.

22. Age-Related Macular Degeneration Treatment. Available [online] at URL: https://www.webmd.com/eye-health/macular-degeneration/age-related-macular-degeneration-treatment#1. As accessed on June 22, 2018.

23. Diabetic Macular Edema. Available[online] at URL: https://www.webmd.com/diabetes/diabetic-macular-edema#1. As accessed on June 19, 2018

24. Raman R and Bhende M. Sci J Med & Vis Res Foun June 2015 | volume XXXIII | number 2.

25. Diabetic Macular Edema. Available [online] at URL: http://eyewiki.aao.org/Diabetic_Macular_Edema. As accessed on June 22, 2018.

26. Anti-VEGF treatment. Available [online] at URL: https://www.rnib.org.uk/eye-health-eye-conditions-z-eye-conditions/anti-vegf-treatment. As accessed on August 9, 2018.

27. DME. Available[online] at URL: https://www.preventblindness.org/diabetic-macular-edema-dme. As accessed on June 22, 2018.

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