Diabetic Macular Edema (DME)

Diabetic Macular Edema (DME) is the leading cause of legal blindness in working age individuals.  It is the result of leakage of liquid from retinal vessels as described in BDR.  In the past, the only treatment for DME has been laser therapy or sometimes vitrectomy.  Current treatment also includes drug therapy, such as steroids and anti-VEGF drugs.

Proliferative Diabetic Retinopathy (PDR)

Proliferative Diabetic Retinopathy or PDR is a more severe form of Diabetic Retinopathy resulting from large areas of reduced circulation and therefore oxygenation of the retina.  This reduced oxygenation stimulates a chemical called vascular endothelial growth factor (VEGF).

This chemical causes  vessels to form which are referred to as new vessels. These new vessels present a risk of bleeding, as well as, leading to scaring and retinal detachment.  These vessels can be treated by laser therapy and pharmacologic methods.

Background Diabetic Retinopathy (BDR/PPDR)

Background or pre-proliferative diabetic retinopathy (BDR/PPDR) shows areas of out pouching (micro aneurisms) of normal retinal vessels and can lead to leakage from these vessels into the retina.  This leakage can be water-like fluid or very viscus fluid containing lipids and cholesterol.  This material called exudates can be locally damaging to the retina.

(BDR/PPDR) is visible usually on clinical examination but often needs optical coherent tomography (OCT) or fluorescein angiography (FA) to identify areas of leakage that may respond to laser or pharmacologic therapy .