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Diabetic macular edema: 'not enough awareness and patient care'

Dec 22nd 2013 at 8:18 PM

Individuals with diabetes have a significantly higher risk of developing diabetic eye disease. But new research reveals that less than 50% of US adults with diabetic macular edema - retina swelling that can lead to blindness - are told by their doctor that diabetes is the cause of their condition, and less than 60% have had a dilated eye exam in the last year.

This is according to a study published in the journal JAMA Ophthalmology.

Diabetic macular edema (DME) is a form of diabetic retinopathy - the leading cause of blindness in diabetics.

DME occurs when the blood vessels in the eye's macula - a part of the retina responsible for sharp vision - leak fluid and swell. This can lead to partial vision loss or total blindness.

Prompt treatment of the condition can prevent blindness. But in order to catch the condition early, diabetic patients need to undergo regular dilated eye examinations.

To determine the awareness of eye care and eye disease among diabetic patients, a team of researchers, led by Dr. Neil M. Bressler of The Johns Hopkins University School of Medicine and Hospital and editor of JAMA Ophthalmology, analyzed 798 participants from the National Health and Nutrition Examination Survey, who had self-reported diabetes.

Of these, 238 had diabetic retinopathy without DME, while 48 had DME.
Diabetics 'not receiving prompt eye care'

Results of the study revealed that only 44.7% of those with DME said they had been told by their doctor that their eyes had been affected by diabetes, or that they had diabetic retinopathy.

Furthermore, only 46.7% of diabetic individuals with DME said they visited a diabetes nurse educator, dietician or nutritionist for their diabetes more than 1 year ago or never, while only 59.7% said they had a dilated eye exam within the past year.

Commenting on their findings, the researchers say:

"Our results suggest that many individuals with DME report not receiving prompt diabetes-related or eye-related care, although many of these individuals are at risk of substantial visual loss that could be lessened or eliminated with appropriate care."

Importance of dilated eye exams

This is not the only study to find that diabetic patients lack awareness when it comes to their risk of diabetic eye disease and the importance of regular dilated eye examinations.

A recent survey from Diabetic Connect - a social networking site for diabetes sufferers and their families - found that 25% of people with diabetes do not have the recommended annual dilated eye exam.
Lady having an eye exam
A new study reveals that less than 60% of diabetic patients have the recommended annual dilated eye exam, and less than 50% know their macular edema is caused by diabetes.

According to the the National Eye Institute, diabetics who undergo a dilated eye exam once a year could reduce their risk of severe vision loss by 95%.

A dilated eye exam involves an ophthalmologist, optometrist or retina specialist putting drops into a patient's eye, which allows them to clearly assess all eye structures - including the retina - to see whether there is any damage or early signs of disease.

Early detection of diabetic eye disease means they can be offered many treatment options to help prevent partial vision loss or blindness.

These include laser eye surgery and injections of anti-vascular growth factor (anti-VEGF) medications, which tackle abnormal blood vessel growth in the eye.
More awareness needed

The researchers say that although treatment for diabetic-related vision loss has improved, their findings suggest that diabetic patients lack awareness when it comes to their risk of diabetic eye disease, and more effort is needed to educate them in this area.

"These efforts include getting patients to health care providers, including diabetes nurse educators, dieticians, nutritionists, primary care physicians, or endocrinologists, for treatment of their diabetes mellitus; getting appropriate eye examinations to detect and treat diabetic retinopathy, including DME," they note.

They add that strategies should be identified that "might result in greater awareness and appropriate eye care to reduce the magnitude of visual impairment and blindness due to this common complication of diabetes mellitus."

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