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Macular Oedema

 

CMO OCT 2

 

Any cause of either temporary or permanent damage to retinal capillaries that makes them leaky can cause macular oedema to develop. This involves fluid leaking out of the blood vessels, making the macula “waterlogged” and swollen. The fluid collects in oval spaces known as ‘cysts’.

What Macular Oedema Symptoms Should I Watch For?

Macular oedema is an often painless condition that has very few symptoms. The macular oedema symptoms that are most often observed include blurred or distorted central vision and differences in colours, such as fading.

Can Macular Edema Be Cured?

The condition cannot be cured, although it can be treated. Retinal capillaries may be leaky for a number of different reasons depending on the underlying disease or type of condition. The choice of treatment type therefore depends on the research evidence available; for most conditions, intravitreal injections are now the main type of treatment. The drug used (anti-VEGF or steroid) depends on the underlying cause (diabetic eye disease, retinal vein occlusion, post-operative macular oedema or macular degeneration). From his specialist clinics in Box Hill and Boronia, Dr Devinder Chauhan is able to provide a number of treatment options for Melbourne patients.

In general, there is fairly good evidence that early treatment of macular oedema has a better visual outcome, almost irrespective of the cause.

What Can Cause Macular Edema?

Conditions that can cause macular edema include diabetic eye diseaseretinal vein occlusions and inflammation after cataract or retinal surgery.

Can Macular Edema Resolve Itself?

While it is possible for it to get better by itself, treatment generally results in better vision and should certainly be sought if there are signs of wet macular degeneration.

Can You Go Blind From Macular Edema?

While you can certainly lose a lot of vision with macular oedema, such that it may only be possible to see hand movements only, the macular edema prognosis is that you won’t go completely blind. Usually, leaving it untreated for too long (how long depends on the condition) results in reduced benefit from treatment or permanently worse vision.

How Is Macular Oedema Diagnosed?

Macular oedema can be seen both on OCT scanning and fluorescein angiography (FA). OCT scanning is better for monitoring the amount of macular oedema, as measurements can be made of the thickness of the macula as well as its volume and changes in both over time. FA is better at demonstrating which capillaries are leaking and whether there are any other causes for the leakiness of the blood vessels.

pseudophakic-cme-OCT.tiff-276x300OCT map of cystoid macular oedema, showing (top) that the macula is thickened centrally and the black spaces (fluid) on the cross-sectional images (left).

pseudophakic-CME-FA-late.tiff-300x204Cystoid Macular Oedema (Edema). Late image from a fluorescein angiogram with central oval collections (cysts) of fluorescein that has leaked out of damaged retinal blood vessels.

 

 

 

 

Read more about the current treatments available:

INTRAVITREAL INJECTION OF ANTI-VEGF ANTIBODY

Intravitreal injection of steroid

Laser

Vitrectomy with inner limiting membrane (ILM) peel