Ayurvedic management of Diabetic macular edema (Pramehajanya Timira): A case report

Diabetic Macular Edema (DME) is the most common cause of visual deterioration in patients affected by diabetes mellitus. During the progression of diabetic retinopathy, at any course, macular edema can develop. The primary symptom of DME is blurry or wavy vision near or in the center of the field of vision. In Ayurveda, DME is not directly described but the etiopathogenesis of eye diseases and Prameha (~diabetes mellitus) gives an idea of a possible correlation between these two diseases. Based on clinical signs and symptoms, DME resembles Timira due to Prameha . Treatment modalities such as intravitreal injections of antivascular endothelial growth factor agents and laser photocoagulation are available for DME in the conventional system of medicine. Although effective, they have certain limitations. Here, presenting the case of a 58-year-old woman, known diabetic for 15 years, with complaints of blurred vision in her left eye. Based on the assessment through Optical Coherence Tomography (three-dimensional Macula), she was diagnosed with DME ( Pramehajanya timira ) and was successfully managed with Ayurveda medicines including Chandraprabha vati , Nishamalaki churna , Katakakhadiradi kashaya, and Nitya virechana (~therapeutic purgation on daily basis) with Erandabhrishta haritaki. Thalapothichil (~covering the scalp with medicaments) was adopted as an external treatment approach. After treatment, there was a reduction in macular edema, along with a reduction in blood sugar levels and significant changes in subjective parameters. The case study inferred that a strategic Ayurveda treatment protocol can help in the reduction of DME, further slowing down the progression of the condition, and preventing diabetic complications.