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What is Diabetic Macular Edema?

By Lauren R. Rosecan, M.D., Ph.D., F.A.C.S. –

What is Diabetic Macular EdemaDiabetic macular edema  (DME) is a swelling or thickening  of the macula, the small area in the center of the retina, which  allows us to see fine details clearly. DME is caused  by fluid leaking from small retinal blood vessels damaged  by diabetes, and this causes  blurred vision. It is .the most common  cause of visual loss in diabetes.  Vision loss can range from  mild to severe, but even in the worst  cases, peripheral vision continues  to function.  Laser treatment  is often recommended for people with DME.

Laser treatment is performed in your doctor’s office or eye clinic as an outpatient procedure. The main goal of treatment is to prevent further loss of vision, but improvement in vision is possible.

Conventional laser treatment for DME uses a continuous-wave laser to create numerous small burns in the retina. While conventional laser is an effective treatment,  the retinal burns, result in permanent  and often progressive retinal scarring, and can cause visual loss.

What is MicroPulse  Laser Therapy?
In contrast to conventional laser treatment, MicroPulse laser therapy (MPLT) has been proven effective without producing laser burns. MPLT chops the continuous-wave laser beam into a train of tiny, repetitive, low energy pulses sepa­ rated by a brief rest period in between.  This “mi­ cropulsing”  allows the retina to cool between  laser pulses, preventing  burns and retinal damage.

With MPLT, risks are reduced or eliminated, with less pain and discomfort than conventional laser treatment; and therefore can be repeated as needed without harm to your vision.

What to Expect during MPLT

Before Treatment
Your doctor will make the diagnosis of DME based on a thorough clinical history and examination, usually involving retinal imaging tests to confirm the diagnoses and to provide additional import­ ant  information. If MPLT is recommended, an in­ formed-  consent form will be given to you for your review and signature,  and all of your questions regarding  treatment will be answered.

During Treatment
To perform MPLT, your eye must be dilated. The  lights in the office will be dimmed  and you will be seated facing the laser machine with your doctor  facing you. A special viewing  lens will be placed  on the front of your eye to perform  MPLT.

A drop of a topical anesthetic makes this comfortable.  Your doctor will place several laser applications in the areas of DME. Treatment usually takes  minutes, and is painless.

Based on the laser wavelength used, you may experience some flashing lights during the proce­ dure. If you move during treatment  there will be no harm to your eye, but it may lengthen the treatment time. At the end of MPLT, the special viewing  lens on your eye will be removed.

After Treatment
For the rest of the day, your vision may be a little blurry. Due to the lens placed  on your eye during treatment,  it is common to experience  a little irritation on the front of your eye for a few hours after treatment. This irritation is usually mild and lessened by use of frequent artificial tear-drops. Significant  pain after treatment  should not occur. If it does, contact  your doctor.  By the next day, your vision should  be as it was before treatment.

Vision improvement typically occurs after months; however, patients may notice better vision within days to weeks  after treatment.

Following MPLT, it is important for you to continue to follow-up with your doctor on a regular basis for continued  monitoring of your condition.  How soon  and how often follow-up  examination is required will be determined  by your doctor.

Lauren R. Rosecan
M.D., Ph.D., F.A.C.S.
The Retina Institute of Florida with four offices
conveniently located in Palm Beach and Martin Counties.

Toll Free Phone Number:  1-800-445-8898 Or 561-832-4411

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