Macular edema



Doctors

Macular edema

What is it?

The central area of ​​the retina, called the macula, is the area that concentrates the most concentrated amount of sensitive cells (cones), and for this reason it is considered one of the most noble parts of the eyeball. The integrity of the macula allows for clear central vision, distinguishing details, reading and recognizing the faces of people, for example.

Macular edema is a common condition, and is caused by an abnormal accumulation of fluid resulting in the expansion and thickening of the intra and extracellular space of the macula, due to a change in the permeability of the capillaries which irrigate it.

It may happen during the evolution of various vascular eye diseases (diabetic retinopathy, the most common, venous thrombosis, perifoveal telangiectasia, radiation retinopathy), during inflammatory processes (anterior or posterior uveitis, vasculitis), postoperative eye surgery (cystoid macular edema or Irvine-Gass syndrome after cataract surgery, even if completed without any complications), in certain congenital dystrophies of the retina (retinitis pigmentosa), associated with intraocular tumors, tensile phenomena (epiretinal membrane syndrome vitreomacular traction), in macular degeneration and even in relation to the use of certain topical eye drops for glaucoma treatment (prostaglandin analogues).

Symptoms

Typical symptoms are blurred and usually painless slowly progressive central vision, although occasionally the disease appears quickly (eg in venous thrombosis of the retina) and the perception of distorted images may appear.

The most common clinical method for determining the presence or absence of macular edema is the stereoscopic clinical examination or with the slit lamp biomicroscope. However, sometimes it is necessary to use additional imaging, optical coherence tomography which allows to evaluate changes in the morphology and thickness of the macula. Fluorescein angiography is a useful test to evaluate the circulatory condition of the retina, where an intravenous contrast material is injected.

Treatment

Effective treatment of macular edema must be based on recognition of the pathogenic factors that cause it. The options are many and include various medical treatments (eye drops, intraocular and periocular injections), laser photocoagulation and vitreoretinal surgery, identifying the best option for each case.

Prevention

These cases usually have a good prognosis with a simple medical treatment, even though a good control of predisposing factors, such as diabetes mellitus or hypertension, among others, is fundamental.

The prognosis is very variable in each situation, and it is convenient in all cases to consult an ophthalmologist retina specialist for accurate diagnosis and the most appropriate treatment.

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