Defining Diabetic Macular Edema

Nicholas G. Anderson, MD, and Philip Niles, MD, MBA, provide an overview of diabetic macular edema (DME) and the impact of vision impairment on a patient’s quality of life.

Jim Kenney, RPh, MBA: Dr. Anderson, what is diabetic macular edema [DME], and how does it compare to wet AMD [age-related macular degeneration]?

Nicholas G. Anderson, MD: Diabetic macular edema is swelling in the macula. Similar to wet macular degeneration, diabetic macular edema is primarily a retinal vascular disease. However, whereas wet macular degeneration is characterized by abnormal new blood vessel growth, diabetic macular edema is primarily caused by damage to existing retinal blood vessels. The prolonged hyperglycemia in patients with diabetes causes damage to the cells lining the retinal blood vessels, which causes them to leak fluid and blood into the macula, resulting in swelling. Over time this swelling damages the photoreceptors, which results in vision loss. Diabetic macular edema typically has a much slower onset and a much slower progression compared to wet macular degeneration.

Jim Kenney, RPh, MBA: Thank you. Dr. Niles, what are the incidence and prevalence rates of wet AMD and DME in the United States?

Philip Niles, MD, MBA: Macular degeneration in general occurs in about 11 million to 15 million people in the United States, and about 10% of those have wet macular degeneration. There are approximately 200,000 new cases of wet macular degeneration diagnosed each year. Regarding diabetic macular edema, about 3.8% of diabetics over age 40 develop diabetic macular edema. But the rates are different depending on ethnicity. It’s approximately 8.4% in non-Hispanic African Americans and 2.6% in Caucasians, according to the NHANES [National Health and Nutrition Examination Survey] database.

Jim Kenney, RPh, MBA: Thank you very much. Back to you, Dr. Anderson. What is the impact of vision impairment on patient quality of life?

Nicholas G. Anderson, MD: Both diabetic macular edema and macular degeneration can have a profound impact on a patient’s quality of life. Wet macular degeneration is the most common irreversible cause of vision loss in the United States, and diabetic macular edema is again one of the leading causes of vision loss in our country. Diabetic macular edema typically impacts patients earlier in life. It therefore has a significant impact not only in their ability to drive, read, use the internet, but also their ability to work. The disease unfortunately often results in occupational disability for affected patients. Wet macular degeneration on the other hand typically affects patients later in their life, so it may not have such a significant impact on their career. But it does again have a very significant impact on their ability to work, drive, read, and other activities of daily living.

Transcript Edited for Clarity

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