Macular Edema

Macular edema can result from pathologic extravasation of fluid through blood vessels in the macular region. This can be a feature of heritable diseases like dominantly inherited cystoid macular edema or acquired causes such as diabetic retinopathy, hypertensive retinopathy, retinal vein occlusions, uveitis, or post-surgical complications. Patients with diabetes, hypertension, hyperlipidemia, non-Hispanic Black race, or those who smoke have a greater risk of developing macular edema. Patients with macular edema typically complain of blurry or distorted vision due to structural changes to the edematous retina. Macular edema may be detected on fundus examination, and optical coherence tomography and fluorescein angiography can be particularly helpful in detecting and monitoring changes in macular edema. These patients are typically treated by a retina specialist with various treatment methods depending on the underlying cause. The mainstay of treatment is intravitreal anti-VEGF therapy, particularly for diabetic macular edema or after retinal vein occlusions. Corticosteroid injections are helpful to treat macular edema related to inflammation. Topical NSAID eye drops may also be used to treat inflammation, especially after ocular surgery. Laser treatment for macular edema has largely been replaced by anti-VEGF therapy. In cases of severe macular edema, vitrectomy can be an effective option for long-term treatment. Screening, early diagnosis, and involving a retina specialist in management are important for preserving or improving vision in patients with macular edema.