| There are new treatments for the treatment of | | | | painless and well tolerated. The injected steroid |
| diabetic macular edema. The standard treatment | | | | may last for several weeks, yet the effects may |
| using retinal laser treatment may become | | | | last for months or longer. |
| obsolete in the near future. New standards and | | | | More recently, sustained release drug delivery |
| technology utilizing intraocular injections and | | | | systems have started to emerge for the |
| sustained release drug delivery will replace the old | | | | treatment of various retinal conditions. Ozurdex |
| standard. | | | | (Allergan) was first FDA approved for the |
| What is Diabetic Macular Edema? | | | | treatment of retinal vein occlusions in the summer |
| Diabetic macular edema is the most common | | | | of 2009. |
| "complication" of diabetic retinopathy. Since almost | | | | While Ozurdex also releases a steroid, it is not |
| all patients with diabetes eventually get some | | | | indicated for the treatment of diabetic |
| degree of diabetic retinopathy in their lifetime, this | | | | retinopathy. (While it would not be wrong for a |
| is the most common manifestation of the disease. | | | | doctor to use this for treating a diabetic patient, it |
| Diabetic macular edema occurs when the normal | | | | does mean that it would not be covered by |
| retinal blood vessels become leaky. The fluid | | | | insurance.) |
| component of blood leaks out of the retinal blood | | | | In the next few months, it is anticipated that a |
| vessels into the surrounding tissue. If the leakage | | | | new sustained delivery device, Iluvien (pSivida |
| occurs in the macula, the condition is called | | | | Alimera Sciences), will be FDA approved, but this |
| macular edema, or, diabetic macular edema. | | | | time, for the treatment of diabetic macular |
| Symptoms of "DME" | | | | edema! |
| Symptoms of "DME" include slight blurring of the | | | | This will be the first drug approved specifically for |
| vision to significant vision loss, but never complete | | | | diabetic macular edema and also utilizing the latest |
| blindness. Patients can become legally blind from | | | | in technology for this novel application. |
| diabetic macular edema. It is fair to say that with | | | | What Does This Mean? It is very exciting to |
| more fluid accumulation, the worse the vision. | | | | introduce newer, and better, methods to treat |
| Treatment of Macular Edema | | | | disease. As a retina specialist, it will be very |
| Traditionally, laser treatment for diabetic macular | | | | exciting to have another treatment in our arsenal |
| edema was performed in an attempt to reduce | | | | for diabetic retinopathy. |
| the amount of fluid accumulation, or, at least, | | | | The era of sustained release medications for the |
| prevent further swelling. Having said that, not all | | | | eye is just starting. More specifically, this means |
| patients were great candidates for laser | | | | that very low doses of medication, steroids, will |
| treatment, some responding better than others. | | | | be released for months inside the eye. The |
| Maintaining status quo, that is, preventing further | | | | medicine has been delivered to its target and will |
| vision loss has always been "success." | | | | release drug for months at a time or longer. |
| Newer Treatments | | | | The early data for Iluvien is quite impressive. The |
| Over the past few years, intraocular injections of | | | | drug may be FDA approved later this year. The |
| steroids have proven to be very successful in | | | | manufacturers of Ozurdex are hoping that it, too, |
| treating this condition. In fact, many patients that | | | | will have an application for diabetic retinopathy. |
| did not initially improve with laser treatment were | | | | The advent of sustained release delivery |
| able to benefit from these injections. | | | | promises to aid us in saving vision from a very |
| A small amount of steroid is injected into the eye, | | | | common problem...diabetes. |
| just to the side of the cornea. The shots are | | | | |