One of the consequences of diabetes is the appearance of a macular edema that can lead to irreversible blindness.
Edemas are a sign that appears in many diseases, such as diabetes, and manifest as a swelling of soft tissues due to the presence of excess fluid in some organ or body tissue.
When that inflammation affects the eyes, specifically the eye macula, we talk about 'diabetic macular edema' (EMD), an ocular pathology that appears as a consequence of the metabolic changes caused by the bad control of blood glucose in people with diabetes.
In the course of the disease, the macula - the part of the retina responsible for the central vision and that allows us to capture the details - inflates and accumulates liquid.This is one of the causes for which diabetic macular edema is the first cause of visual loss in diabetic people.
Approximately 7.6 percent of diabetes patients in the world suffer from this problem.This means that, in Spain, about 300,000 people suffer from this pathology, which can lead to irreversible blindness if not.And as edema progresses, its inflammatory component also increases.
This visual condition may also be associated with other ocular pathologies, such as: diabetic retinopathy, macular degeneration associated with age, uveitis, some types of retinitis, some tumors in the eye and genetic disorders, such as some form of macular dystrophy.
That is why the specialists highlight the importance of going to ophthalmology reviews to prevent this type of irreversible injuries and remember that an interruption of treatment involves a loss of visual acuity and a worsening of the quality of life.
With the proper treatment, edema can be avoided to cause the deterioration of the macula, reducing edema before it is chronified and the damage is irreversible.
“EMD chronicity increases the inflammatory component of edema.A correct choice of treatment at the right time, which takes into account said component, increases the probability of achieving a greater visual gain, ”explains Dr. Javier Zarranz-Ventura, an ophthalmology specialist at the Clinic Hospital in Barcelona.The way to achieve this is why, exactly, at what moment of the disease is the patient.
Specifically, macular edema is classified into four phases (early, advanced, serious and atrophic), according to the European School for Advanced Studies in Ophthalmology (Esaso).The most decisive are advanced and serious, especially because the response to treatment differs considerably depending on which of these two stages the patient is.
Through different tests and measurements, ophthalmologists can identify the severity of macular edemas and provide individualized treatment thanks to the measurement of biomarkers, the substances present in the body (or that are introduced) and that allow detecting a disease or helping usnamely how it will evolve.
These include neurosensory detachment (DNS), present in up to 30 percent of patients with diabetic macular edema;the presence of hyperreflective points (HRF), with a prevalence of approximately 41 percent;The size of the big intrarestinian cysts, which appear in approximately 17 percent of patients;and the high central macular thickness (& GT; 450µm) suffered by 41.6 percent of people with EMD.
Among the algorithms and criteria to define the most appropriate treatment, the observation of the lens is very widespread, a lens that is behind the iris and in front of the vitreous humor and its main function is to focus the images.HeState in which it is usually one of the first issues to take into account when choosing what therapy use against EMD.However, “the status of the lens should not be the criterion for the choice of treatment, but the condition we are dealing with, that is, the macular edema that can cause irreversible blindness.It would be more successful to first assess the type of edema that the patient has and then take into account other ocular factors, ”concludes Dr. Patricia Udaondo, the optional of the ophthalmology service of the University and Polytechnic Hospital La Fe and co -director of the Aiken Clinic in Valencia.
