Cystoid Macular Edema

introduction

What is Cystoid Macular Edema?

The macula is the part of the retina that helps us see fine detail, faraway objects, and color. Cystoid Macular Edema (CME) is a painless disorder in which swelling develops in the macula. As the swelling increases, multiple fluid filled cysts develop in the macula.

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 Cystoid Macular Edema

  • Recent eye surgery (particularly cataract surgery)
  • Diabetic retinopathy
  • Uveitis
  • Retinal vascular disease
  • Age related macular degeneration
  • Injury to the eye
  • Side effects of medications

Cystoid Macular Edema Risk Factors

  • Surgical causes (following eye surgery)
  • 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)

Macular Edema Diagnosis

A routine dilated fundus examination by the ophthalmologist aids in the diagnosis. Further tests can be ordered to document and measure the thickness of the macula.

  • 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.

 

Written by: Dr. Karpagam – Chairman, Education Committee

FAQ

How long does it take for macular edema to resolve?

The macular edema may take up to a month to approximately four months to go away.

If  left untreated, chronic macular edema can lead to irreversible damage of the macula and permanent vision loss. Otherwise macular edema is treatable.

Rarely, macular edema will go away on its own. However, if you have symptoms of macular edema, it’s important that you see an ophthalmologist right away. If left untreated, macular edema can cause severe vision loss and even blindness. There are several treatment options available for macular edema.

Macular edema is reversible in the early stages but chronic edema may lead to irreversible changes in the retina.

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