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Macular Oedema Macular Oedema

Macular Oedema 

Macular oedema occurs when fluid accumulates in the macula, leading to swelling. The swelling may affect vision, making objects appear blurred, wavy and colours appear faded. If untreated, macular oedema can cause permanent reduced or loss of vision. 

Causes of macular oedema 

Macular oedema results from pockets of fluid in the macula. The fluid usually comes from leakage in damaged blood vessels. 

Different conditions can cause fluid leakage into the retina, causing macular oedema. These conditions include:

  • Diabetes 

People with diabetes have a high risk of high blood sugar damaging retinal blood vessels that leak into the macula. 

  • Age-related macular degeneration (AMD)

In AMD, abnormal blood vessels develop, which leak blood and other fluid into the retina and cause swelling in the macula. 

  • Macular pucker/vitreomacular traction 

Partial vitreous detachment in an ageing eye may tug in the macular tissue or form scar tissues, including pockets of fluid under it. 

  • Retinal vein occlusion (RVO)

RVO is a blood vessel disease where the retinal veins become blocked, causing blood and fluid to leak into the macula.

  • Genetic disorders 

These include retinitis pigmentosa or retinoschisis.

  • Inflammatory eye diseases

These include conditions such as uveitis. In this condition, the body attacks tissues, damaging retinal blood vessels, leading to macular swelling. 

  • Medication 

Certain medications have side effects that may cause macular oedema.

  • Eye tumours 

Both malignant and benign eye tumours can cause retina and macular oedema.

  • Eye surgery 

Patients may get macular oedema in rare cases after retinal, cataract, or glaucoma surgery. 

  • Injuries 

Trauma to the eye may cause macular oedema.

Symptoms 

Swelling in the macula is usually painless and causes no symptoms in the early stages. When symptoms are present, they indicate leakage in blood vessels. 

Common macular oedema symptoms include:

  • Difficulty reading 
  • Wavy or blurred central vision 
  • Colours appearing faded or different

If you experience symptoms of macular oedema, visit your ophthalmologist as soon as you can. Untreated macular oedema may lead to severe vision loss or blindness, 

Diagnosis 

Your eye surgeon(ophthalmologist )will carry out an eye exam. They will put dilating eye drops during the exam to widen the pupil for a clearer view of the retina inside the eye. The ophthalmologist may also perform other tests for a more detailed retina exam. 

These tests include:

  • Optical coherence tomography (OCT)

OCT helps the doctor to examine the retina closely. This machine scans all layers of retina, providing detailed images to determine its thickness, which helps the doctor check for leakages and measure macular swelling. 

  • Fluorescein angiography 

The doctor will inject a yellow dye, known as fluorescein, into the vein through the arm. The dye will travel through your blood vessels. The doctor will use a special camera to take photos of the retina as the dye travels in the blood vessels. The dye shows the bleeding blood vessels and the amount of leakage. Modern version of OCT called OCT Angiogram can show blood vessels without dye available at Optimal Vision .

Treatment 

The suitable treatment will require treating the underlying cause of macular oedema, retinal swelling, and leakage. 

Possible treatments include:

  • Medication injections 

These medications are known as anti-VEGF. This treatment helps to reduce the new, abnormal retinal blood vessels and the leakage from blood vessels. The eye doctor will inject the medication into the eye with a small needle which is done under local anaesthesia with minimal discomfort.

  • Steroid treatment 

When inflammation causes macular oedema, the doctor may administer steroid medication. The medication may be in the form of injections, pills, or eye drops. 

  • Eye drop medication

The doctor may prescribe non-steroidal or steroidal anti-inflammatory (NSAID) eye drops when cystoid macular oedema occurs after cataract surgery. You will use the eye drops for a couple of months. 

  • Laser treatment 

If indicated the surgeon will apply several small laser pulses to the areas leaking fluid around the macula to seal the leak with laser treatment. This treatment aims to seal off leaking blood vessels and stabilise vision.  

  • Vitrectomy surgery 

If macular oedema results from the vitreous(gel in the back of the eye) pulling on the macula, the surgeon will carry out vitrectomy surgery to restore the macular to its normal size and release the traction. This procedure involves using small instruments to remove the vitreous from the eyes and then peeling the scar tissues in the macula to relieve the traction damaging the macula. 

Your treatment plan for macular oedema will depend on the condition's cause. It will take several months for the swelling to reduce in some cases. Ensure you follow your doctor's instructions for the treatment to be effective.  

For a consultation to determine the cause of swelling in your macula, visit Optimal Vision. You can also contact us on 020 7183 3725 to schedule an appointment with our experienced ophthalmologist. 

Dr Amir Mani - Specialist refractive surgeon

One of the most experienced refractive surgeons in London

Dr Mani has performed more than 20,000 ophthalmic procedures, including LASIK, LASEK, PRK, Femto Cataract, RLE, Lens ICL and Phakic IOL Surgery

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