Macular Edema
Macular edema happens when blood vessels leak into a part of the retina called the macula.
Macular Edema:
What is Macular Edema?
The macula is located in the retina and is responsible for central vision, including the ability to see fine detail, distance, and colour. When aberrant fluid accumulates in the macula, a condition known as macular edoema occurs. Increased leaking from damaged retinal blood vessels or the formation of aberrant blood vessels in the retina are the most common causes of this condition.
Symptoms of Macular Edema:
It’s a painless condition and usually asymptomatic in the early stages. Patients may later develop
Blurred or wavy central vision
Colors may appear different
May experience difficulty in reading
Causes of Macular Edema
Diabetes: High blood sugar levels due to Diabetes causes leaky blood vessels at the macula.
Age related Macular Degeneration: Here abnormal blood vessels leak fluid and cause macular swelling.
Retinal Vein oclussions:When the veins in the retina become blocked,blood and fluid then leak out into the macula.
Vitreomacular traction (VMT)
Genetic/Hereditary disorders:such as Retinoschisis or Retinitis Pigmentosa.
Inflammatory eye diseases: Conditions like uveitis, where the body attacks its own tissues, can damage retinal blood vessels and cause swelling of the macula.
Medication: Certain drugs have side effects that can lead to macular edema.
Eye Malignancies: Both benign and malignant tumors can lead to macular edema.
Eye surgery. It’s not common, but sometimes after glaucome, retinal or cataract surgery, you can get macular edema.
Injuries. Trauma to the eye.
Cystoid Macular Edema
There are various types of cataracts. They are classified by how and where they are developed in your eye. There are Nuclear cataracts formed in the middle of the lens and causes the nucleus or the centre of eye to become yellow and brown.
Macular Edema Risk Factors
Metabolic conditions (diabetes)
Blood vessel diseases (vein occlusion/blockage)
Aging (macular degeneration)
Traction on the macula (macular hole, macular pucker, and vitreomacular traction)
Inflammatory conditions (sarcoidosis, uveitis)
Toxicity
Neoplastic conditions (eye tumors)
Trauma
Surgical causes (following eye surgery)
Unknown (idiopathic) causes
Prevention
Macular Ed
Macular Edema Prevention
The eyes of people with diabetes should be examined once a year.
It is recommended that people with a family history or underlying genetic problem get annual eye exams.
Macular Edema Diagnosis
An ophthalmologist can help with the diagnosis by doing a dilated fundus examination. Extra examinations can be requested to record and quantify macula thickness.
- Optical Coherence Tomography (OCT): It scans the retina and provides very detailed images of its thickness. This helps your doctor find leakage and measure swelling of the macula.It can also be used to follow the response to treatment
- Fundus Fluorescein Angiography(FFA): For this test, fluorescein dye is injected into a peripheral vein in the hand or forearm. A series of photographs is taken of the retina as the dye passes through its blood vessels
Macular Edema Treatment
First and foremost is addressing the underlying cause of the macular edema, and the related leakage and retinal swelling.
Treatment can include:
- Topical NSAIDS: Non Steroidal anti inflammatory drugs can be given as eye drops to cure the swelling.
- Steroid treatment: When macular edema is caused by inflammation, steroids can be given either as drops,tablets or as injections into the eye.
- Intravitreal injections: Anti Vascular Endothelial Growth Factor( Anti-VEGF)medicines given as intravitreal injections into the eye helps to reduce the growth of abnormal blood vessels in the retina, and also decreases leaking from blood vessels.
- Laser treatment: With this tiny laser pulses are applied to the areas of fluid leakage around the macula. The goal is to stabilize vision by sealing off leaking blood vessels
- Vitrectomy surgery: When macular edema is caused by vitreous pulling on the macula, a procedure called a vitrectomy may be needed to restore the macula to its normal (lying flat) shape.