¿Qué es el edema macular?

Macular edema is the swelling or thickening of the macula, a part in the retina in charge of central vision that allows us to capture details. This area of the eye is vital for proper visual quality.

How is macular edema produced?

Macular edema occurs when liquids accumulate in the macula from the blood vessels that irrigate the retina, due to an abnormality of these vessels, or because their walls are too thin and become permeable. This fluid accumulation inflames the macula.

In many cases of macular edema, peripheral vision is maintained, although central vision is altered in an intensity that may vary (mild or severe).

Causes

Occasionally, this condition may occur after eye surgery. In the case of macular edema that appears after cataract surgery, it is known as cystoid macular edema (CME).

However this visual condition can also be associated with other ocular pathologies, such as:

This disorder can also be caused by eye injuries or side effects of certain drugs.

In the case of those affected by diabetes, macular edema is usually the most common reason for vision loss.

Symptoms

Macular edema may appear silently at first, i.e., with few symptoms. It is also characterized for being a painless condition.

As it progresses, macular edema may present with the following symptoms:

  • loss of central vision
  • blurred vision
  • distortion of straight lines

In some cases, macular edema may appear rapidly, such as in the case of retinal vein thrombosis.

How is it diagnosed?

The most common clinical tests to diagnose macular edema are:

  • Eye examination with a biomicroscope or slit lamp.
  • Optical coherence tomography (OCT) to verify the thickness and morphology of the macula. This test checks for fluid accumulation.
  • Fluorescein angiography to check for fluid leakage in the blood vessels.

Treatment

In case of macular edema, the ophthalmologist will prescribe the most appropriate treatment depending on the cause, evolution and medical history of the patient.

The most common treatments are:

  • Eye drops and/or anti-inflammatory drugs, in less severe cases.
  • Focal laser surgery to reduce blood vessel leaks. The objective is to seal the leaks with small laser pulses in the macula to stabilize the patient’s vision. In some cases, several laser sessions are necessary to achieve improved vision. If macular edema has occurred in both eyes, treatment will be applied to one eye and, a few weeks later, to the other eye.
  • Treatment with drugs administered into the eye by intravitreal injections. The drugs used are steroids and endothelial growth factor inhibitors (anti-VEFG) to reduce the growth of blood vessels and make leakage more difficult. These drugs are injected into the vitreous cavity through an injection. The injections are performed under topical anesthesia, which make it a painless treatment.

Can macular edema be prevented?

Macular edema is sometimes associated with other pathologies such as diabetes. In these cases, it will be necessary to control this disease, making sure that the sugar levels are correct.

Macular edema cannot be prevented, although it can be detected early if periodic eye check-ups are performed, especially when predisposing factors are present.

Medical content revised by - Last revision 02/09/2024

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