Macular Edema

Update Item Information
Identifier Macular_Edema_NOVEL_24
Title Macular Edema
Creator Stephanie Chau Nguyen; James Brian Davis; Amanda Dean Henderson
Affiliation (SCN) Medicine, Georgetown University School of Medicine; (JBD) (ADH) Neuro-Ophthalmology, Wilmer Eye Institute, Johns Hopkins Medicine
Subject Anti-VEGF; Diabetes; DME; Macular Edema; OCT
Description 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 Laser treatment for macular edema has largely been replaced by anti-VEGF therapy.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.
Date 2024-04
References 1. Garg, Pooja. "File:Disc 1.JPG - Eyewiki." EyeWiki, 2013, eyewiki.aao.org/File:Disc_1.JPG. 2. Garg, Pooja. "File: Late FA Left Eye CME." EyeWiki, 2013, eyewiki.aao.org/File:Late_FA_Left_Eye_CME.jpg. 3. Hossain, Kabir. "File: Cystoid Macular Edema." EyeWiki, 2019, eyewiki.aao.org/File: Cystoid Macular Edema. 4. Hwang, S., Kang, S.W., Kim, K.T. et al. Three-year outcomes of vitrectomy combined with intraoperative dexamethasone implantation for non-tractional refractory diabetic macular edema. Sci Rep 11, 1292 (2021). https://doi.org/10.1038/s41598-020-80350-w. 5. Johnson MW. Etiology and treatment of macular edema. Am J Ophthalmol. 2009;147(1):11-21.e1. doi:10.1016/j.ajo.2008.07.024. 6. Klein R, Klein BE, Moss SE, Cruickshanks KJ. The Wisconsin Epidemiologic Study of Diabetic Retinopathy. XV. The long-term incidence of macular edema. Ophthalmology. 1995;102(1):7- 16. doi:10.1016/s0161-6420(95)31052-4. 7. Kohli P, Patel BC. Macular Edema. [Updated 2023 Apr 3]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK576396/. 8. Lee R, Wong TY, Sabanayagam C. Epidemiology of diabetic retinopathy, diabetic macular edema and related vision loss. Eye Vis (Lond). 2015;2:17. Published 2015 Sep 30. doi:10.1186/s40662-015-0026-2. 9. Leng, T., & Tripathy, K. (2023, November 1). Diabetic macular edema - EyeWiki. American Academy of Ophthalmology. https://eyewiki.aao.org/Diabetic_Macular_Edema. 10. Lin Y, Ren X, Chen D. Steroid Treatment in Macular Edema: A Bibliometric Study and Visualization Analysis. Front Pharmacol. 2022;13:824790. Published 2022 Feb 22. doi:10.3389/fphar.2022.824790. 11. Lin KY, Hsih WH, Lin YB, Wen CY, Chang TJ. Update in the epidemiology, risk factors, screening, and treatment of diabetic retinopathy. J Diabetes Investig. 2021;12(8):1322-1325. doi:10.1111/jdi.13480; 12. Macula. American Academy of Ophthalmology. Published March 28, 2016. https://www.aao.org/eye-health/anatomy/macula-6. 13. National Eye Institute. www.nei.nih.gov. Accessed January 22, 2024. https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/macular-edema#section-id-1183; 14. Russo A, Costagliola C, Delcassi L, et al. Topical nonsteroidal anti-inflammatory drugs for macular edema. Mediators Inflamm. 2013;2013:476525. doi:10.1155/2013/476525. 15. Scott IU, VanVeldhuisen PC, Oden NL, Ip MS, Blodi BA; SCORE2 Investigator Group. Month 60 Outcomes After Treatment Initiation With Anti-Vascular Endothelial Growth Factor Therapy for Macular Edema Due to Central Retinal or Hemiretinal Vein Occlusion. Am J Ophthalmol. 2022;240:330-341. doi:10.1016/j.ajo.2022.04.001. 16. Thorne JE, Daniel E, Jabs DA, Kedhar SR, Peters GB, Dunn JP. Smoking as a risk factor for cystoid macular edema complicating intermediate uveitis. Am J Ophthalmol. 2008;145(5):841-846. doi:10.1016/j.ajo.2007.12.032. 17. Trichonas G, Kaiser PK. Optical coherence tomography imaging of macular oedema. Br J Ophthalmol. 2014;98 Suppl 2(Suppl 2):ii24-ii29. doi:10.1136/bjophthalmol-2014-305305. 18. Varma R, Bressler NM, Doan QV, et al. Prevalence of and risk factors for diabetic macular edema in the United States. JAMA Ophthalmol. 2014;132(11):1334-1340. doi:10.1001/jamaophthalmol.2014.2854. 19. Virgili G, Parravano M, Evans JR, Gordon I, Lucenteforte E. Anti-vascular endothelial growth factor for diabetic macular oedema: a network meta-analysis. Cochrane Database Syst Rev. 2017;6(6):CD007419. Published 2017 Jun 22. doi:10.1002/14651858.CD007419.pub5. 20. Williams, R., Airey, M., Baxter, H. et al. Epidemiology of diabetic retinopathy and macular oedema: a systematic review. Eye 18, 963-983 (2004). https://doi.org/10.1038/sj.eye.6701476
Language eng
Format video/mp4
Type Image/MovingImage
Collection Neuro-Ophthalmology Virtual Education Library: NOVEL https://NOVEL.utah.edu
Publisher North American Neuro-Ophthalmology Society
Holding Institution Spencer S. Eccles Health Sciences Library, University of Utah
Rights Management Copyright 2024. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright
ARK ark:/87278/s64hvsb3
Setname ehsl_novel_novel
ID 2483662
Reference URL https://collections.lib.utah.edu/ark:/87278/s64hvsb3
Back to Search Results