
05/05/2025
Diabetic macular edema(DME):
▪️Chronic hyperglycemia-related accumulation of advanced glycated end products disrupts the blood–retina barrier (BRB), leading to endothelial cell junction breakdown and pericyte loss.
▪️The inner BRB is composed of endothelial cells in the retinal capillaries, while the outer BRB is composed of retinal pigment epithelium cells.
▪️When the BRB is altered, interstitial fluid is accumulated within and underneath the retina through leakage of molecules dependent on intact cell-to-cell junctions.
▪️ Risk Factors:
➖Risk factors for DME and DR are similar.
➖These include a longer DM duration, poor control of DM with elevated glycolated hemoglobin A1c (HbA1c) levels, hypertension, and hyperlipidemia.
➖Other secondary risk factors include impaired renal function and the use of thiazolidinediones.
▪️Photo: A: Schematic diagram of DME.
➖Microaneurysms, or damaged capillaries, resulting from the breakdown of the BRB leak fluid to the extracellular space, resulting in a swollen retina.
➖Resorption of DME is dependent on the adjacent capillaries and RPE.
➖Resorption of fluid may leave behind lipoprotein residues, seen here as exudates.
▪️B: OCT image of DME.
Credit: www.eyewiki.org