Diabetic Macular Edema (DME)

People with diabetes are more likely to suffer a condition that may damage their eyesight. One of those conditions is diabetic macular edema, which affects one in every three long-term diabetics.

The eye, the retina and the macula

Your retina is the tissue at the back of your eye that enables you to see. It contains cells called photoreceptors that convert light coming into your eye into signals that your brain can understand. There are two types of photoreceptors: rod cells, which are sensitive to low light levels; and cone cells, which allow you to see color.

Cone cells are tightly packed in a region of the retina called the macula, which gives you your central vision, and is necessary for many daily activities such as reading or driving a car.

What is diabetic macular edema (DME)?

The retina contains many small and delicate blood vessels, known as capillaries, that supply oxygen and nutrients to the photoreceptors. In diabetes, the amount of sugar in the blood is higher than normal. If not controlled, high blood sugar can damage the capillaries in the retina.

Damaged capillaries cause the release of a protein called vascular endothelial growth factor (VEGF). VEGF causes capillaries to leak fluid into the macula, the point of sharpest vision on the retina. It also makes new blood vessels grow (neovascularization), which can also leak fluid.

The leaked fluid causes swelling (edema) – known as diabetic macular edema (DME) – that distorts the macula, resulting in blurred vision. If not treated, DME can result in complete loss of central vision.

Approximately, one in every three people who have had diabetes for 20 years or more will develop DME.¹ Today approximately 27 million people globally live with DME.²

How can I prevent DME happening to me?

If you have diabetes, the most important thing you can do is to ensure that your blood sugar level is well-controlled, to avoid damaging the fragile capillaries in your eye. Your physician will be able to advise you if you have concerns about your diabetes treatment.

It is also important to visit an eye specialist regularly, so that any signs of capillary damage in the retina can be picked up and treated, as early as possible. If you experience blurred vision, you should immediately report this to an eye specialist.

How is DME treated?

There are a number of different ways to treat DME. Some patients with DME are treated with a special laser that seals leaky capillaries and reduces swelling, while others are treated with steroids, injected directly into the eye, to reduce inflammation.

Another class of medicines, known as anti-VEGF therapies, target the vascular endothelial growth factor (VEGF). When injected into the eye, these medicines stop the VEGF protein from acting and allow existing swelling to reduce. Anti-VEGF therapies are more effective than laser or steroid treatment for DME.³

Anti-VEGF therapies can cause existing edemas and new, pathologically formed blood vessels in the choroid to recede. This means photoreceptor cells that have not yet been completely destroyed, can be saved, which can stop progressive blindness, and even improve visual acuity in some patients.

Conventional anti-VEGF therapies require frequent treatment injections, which can place a high disease burden on patients, and some DME patients can struggle with adherence. Additionally, as the injections need to be administered in a healthcare facility, the disease burden can extend to patients’ carers. 

Treatment options that offer extended treatment intervals can meet an important unmet need for DME patients by reducing the number of injections required, allowing patients to spend more time doing things that are important to them.
 

Bayer is committed to advancing treatment options that benefit patients in need.


Sources:
 

[1] Duphare C, et al. Diabetic macular edema. In: StatPearls [Internet]. USA: StatPearls Publishing. 2023.

[2] Cheung N, et al. Eye (Lond) 2020;34:999–1002.

[3] Blinder et al. 2017. Anti-VEGF treatment of diabetic macular edema in clinical practice: effectiveness and patterns of use (ECHO Study Report 1). Available at: https://doi.org/10.2147%2FOPTH.S128509