Diabetic Retinopathy Vs. Diabetic Macular Edema: Your FAQs Answered

Diabetic retinopathy and diabetic macular edema (DME) are two of the most common vision conditions related to diabetes.

They affect about 1 in 4 people with type 1 and type 2 diabetes, according to a 2016 study.

While both conditions can cause blindness, the two have some key differences that are important to understand.

Let’s go over some of the most frequently asked questions about diabetic retinopathy and macular edema, as well as what you need to know to protect your vision if you live with these conditions.

Is diabetic retinopathy the same as diabetic macular edema?

Diabetic retinopathy and DME aren’t the same thing.

Diabetic retinopathy is a complication of diabetes that can lead to vision loss. It can also result in other complications, including DME.

Here’s a more in-depth look at diabetic retinopathy and DME:

Diabetic retinopathy

Diabetic retinopathy happens when diabetes damages the retina, a thin layer of tissue located in the back of your eye near the optic nerve.

The retina is vital to eyesight. It’s needed to sense light and send information to the brain.

The longer you have diabetes, the more likely you are to have retinopathy. It’s a progressive condition that typically affects both eyes.

It can occur when your blood sugar level is too high for too long. This can interfere with blood flow and damage small blood vessels, including those that go to the retina.

As the vessels bulge and weaken, blood and other fluid leak into the retina. This process can be slow, and you may not notice symptoms for a while.

You may be able to slow to progression of the disease further by keeping your blood sugar levels under control.

When the condition is in its earliest stage, it’s called nonproliferative diabetic retinopathy.

The advanced stage is called proliferative diabetic retinopathy. That’s when the eye begins to form new blood vessels to increase the blood supply to the retina.

This new growth can cause scar tissue and lead to:

    DME
  • retinal detachment
  • vitreous hemorrhage
  • pressure in the eyeball
  • nerve damage
  • glaucoma
  • partial or complete vision loss

While the condition can affect people with type 1 or type 2 diabetes, it tends to be more prevalent in those with type 1.

Approximately 75 percent of people with type 1 diabetes and 50 percent with type 2 diabetes develop retinopathy at some point in their lives, according to a 2017 study.

Diabetic macular edema

DME is a complication of diabetic retinopathy that affects the macula, which is located at the center of the retina and responsible for central vision.

The macula helps you see color, fine details, and distant objects. It sends information to the brain that gets interpreted into images. It’s needed for everything from recognizing faces to reading.

Diabetic retinopathy causes DME when the retina can no longer absorb the fluids from those leaky blood vessels. That, in turn, causes the macula to thicken and swell.

The swelling can be confined to a small area or widespread. More swelling tends to cause more symptoms.

Symptoms of DME include:

  • blurry vision
  • double or wavy vision
  • floaters
  • blind spots
  • colors appearing dull
  • trouble with facial recognition
  • partial or complete vision loss

If you have DME, you might have trouble with tasks that require precise vision, like threading a needle or reading small print. But it’s also possible to have advanced DME without any symptoms at all.

For people with diabetic retinopathy, macular edema is the most common cause of vision loss.

Can you have diabetic macular edema without diabetic retinopathy?

No. DME is a complication of diabetic retinopathy, so you’ll have both if you have DME. You can have diabetic retinopathy without DME, though.

That said, diabetic retinopathy isn’t the only cause of macular edema. Even people without diabetes can get macular edema from:

  • complications of eye surgery for cataracts, glaucoma, or retina diseases
  • age- related macular degeneration
  • blocked retinal blood vessels (retinal vein occlusions) due to high blood pressure, glaucoma, and age-related atherosclerosis
  • inflammation from conditions such as uveitis, retinal necrosis, and toxoplasmosis

Is macular edema a retinopathy?

Even though the macula is part of the retina, macular edema is not a retinopathy. It’s a complication of diabetic retinopathy or some other condition.

Does diabetes cause macular edema?

Yes, diabetes is one potential cause of macular edema. Persistently high blood sugar levels affect can affect blood vessels in the eye, causing them to leak. That, in turn, results in swelling of the macula and DME.

DME affects more than 28 million people around the world, according to the International Diabetes Federation. About 20 percent of people with type 1 diabetes and up to 25 percent of people with type 2 diabetes develop DME after 10 years, according to research from 2016.

In the United States, approximately 7.7 million people have diabetic retinopathy. Of those, 750,000 also have DME, per the National Eye Institute.

DME can occur at any stage of diabetic retinopathy, but the risk increases as the condition progresses.

DME is more common in men than women. You may also be at higher risk of DME if you have the following conditions:

  • high blood sugar (hyperglycemia)
  • abnormal blood lipid levels (dyslipidemia)
  • obesity
  • sleep apnea
  • pregnancy with preexisting diabetes (not gestational diabetes)
  • kidney problems

Takeaway

Diabetes can lead to a vision condition known as diabetic retinopathy. That can also cause a serious complication known as DME. Both conditions can cause blindness.

You may not notice any symptoms of diabetic retinopathy at first, so regular vision screenings are an important part of your care if you have diabetes.

When caught early, diabetic retinopathy can be treated to help protect your vision and prevent DME.

If you notice symptoms like blurry vision or floaters, speak with an eye care professional to get tested for DME.

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