Macular Edema

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    What is Macular Edema?

    Understanding About
    Macular Edema

    Macular Edema is a nonspecific sign or consequence of various intraocular and systemic conditions, leading to significant visual impairment. 

    Macular edema is characterized by localized swelling in the macular area, resulting in increased central retinal thickness. Initially, fluid accumulates in the outer plexiform layer (OPL) and/or the inner nuclear layer (INL), with swelling of Müller cells also observed. This fluid accumulation may involve intracellular and/or extracellular retinal spaces.

    The macula is particularly susceptible to edema due to its unique anatomical features. Factors predisposing the macula to edema include a high rate of fluid production due to its high cell count and metabolic activity, a low rate of extracellular fluid resorption owing to the presence of a central avascular zone, and the arrangement of the Henle fiber layer, which facilitates fluid accumulation in the region.

    Types of Macular Edema

    Different Types of
    Macular Edema

    Diabetic Macular Edema (DME)

    • Caused by breakdown of the inner blood-retinal barrier (BRB) due to hyperglycemia, leading to vascular dysfunction. In later stages, the outer BRB is compromised. Factors include ischemia, reactive oxygen intermediates, extracellular matrix degradation, and abnormal autoregulation.

    Retinal Vein Occlusions

    • Outer BRB disruption due to ischemia, raised hydrostatic pressure, and turbulent blood flow.

    Coat Disease

    • Inner BRB disruption due to retinal vascular endothelial damage and abnormal pericytes, leading to telangiectasias and retinal ischemia.

    Retinal Artery Macroaneurysms (RAM)

    • Weakening of blood vessel walls due to chronic hypertension, arteriosclerosis, and focal ischemia.

    Radiation Retinopathy (RR):

    • Free radicals cause vascular damage, leading to capillary nonperfusion similar to diabetic retinopathy. Results from radiation exposure with defined tissue tolerance doses.

    Hypertensive Retinopathy (Stage IV)

    • Outer BRB disruption due to choroidal ischemia and resultant retinal pigment epithelium (RPE) damage.

    Irvine-Gass Syndrome

    • Surgical trauma releases inflammatory mediators, disrupting the blood-aqueous barrier and increasing perifoveal capillary permeability.

    Inflammatory Disorders

    • Prostaglandin release leads to BRB breakdown.

    Non-arteritic Anterior Ischemic Optic Neuropathy (NAION)

    • Fluid percolation from the peripapillary choroid causes macular edema.

    Edema after Panretinal Photocoagulation (PRP)

    • Inflammation-induced during the procedure and increased macular blood flow secondary to laser cause edema.

    Drug-induced Macular Edema

    • ITopical epinephrine, systemic tamoxifen, systemic nicotinic acid, and topical latanoprost disrupt the BRB.

    Choroidal Tumors

    • Cystoid macular edema and subretinal fluid occur due to chronic inflammatory cell infiltration and abnormal leaking vessels.

    Retinitis Pigmentosa (RP)

    • BRB breakdown due to toxic products from degenerating retinal cells, RPE pumping mechanism failure, and muller cell dysfunction.

    Macular Edema FAQs

    Macular Edema
    FAQS
    Blurry vision and vision that gets worse over time are the main symptoms of macular edema.

    Macular edema happens when blood vessels leak into a part of the retina called the macula. This makes the macula swell, causing blurry vision.

    There are many different conditions that can cause macular edema. The most common one is diabetic retinopathy — an eye condition that causes vision loss in people with diabetes. When diabetic retinopathy causes macular edema, it’s called diabetic macular edema (DME).

    If you have diabetic retinopathy, managing your diabetes can help prevent or delay vision loss. It’s also important to get a dilated eye exam at least once a year.

    Eye doctors can check for macular edema as part of a dilated eye exam. The exam is simple and painless. Your doctor will give you some eye drops to dilate (widen) your pupil and take a look at the retina.

    Macular edema is swelling in part of the retina (the light-sensitive layer of tissue at the back of your eye). People with macular edema may have blurry vision, but treatment can help reduce the swelling and prevent vision loss.

    NEI funds research that explores better ways to prevent and treat macular edema. Currently, NEI researchers are comparing different anti-VEGF drugs and studying alternatives to anti-VEGF treatment.

    NEI also funds research on diseases that cause macular edema, like diabetic retinopathy and retinal vein occlusion.