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Macular edema

Macular edema is the build-up of fluid in the macula, an area in the center of the retina. The retina is the light-sensitive tissue at the back of the eye, and the macula is the part of the retina responsible for sharp, straight-ahead vision. Fluid build-up causes the macula to swell and thicken, which interferes with vision.

What are the symptoms of macular edema?

The main symptom of macular edema is blurred or wavy vision near or in the center of your field of vision. Colors can also appear washed out or faded. Most people with macular edema have symptoms that range from mildly blurred vision to noticeable vision loss. If only one eye is affected, you may not notice that your vision is blurred until the condition is advanced.

What Causes Macular Edema?

Macular edema occurs when there is abnormal leakage and accumulation of fluid in the macula from damaged blood vessels in the nearby retina. A common cause of macular edema is diabetic retinopathy, a disease that can happen to people with diabetes. Macular edema can also occur after eye surgery, in conjunction with age-related macular degeneration, or as a result of inflammatory diseases affecting the eye. Any disease that damages the blood vessels in the retina can cause macular edema.

Diabetic Macular Edema (DME)

Diabetic macular edema (DME) is caused by a complication of diabetes called diabetic retinopathy. Diabetic retinopathy is the most common diabetic eye disease and the leading cause of irreversible blindness in working-age Americans. Diabetic retinopathy usually affects both eyes.

Diabetic retinopathy is caused by sustained damage to the small blood vessels of the retina. The leakage of fluid into the retina can cause swelling of the surrounding tissue, including the macula.

DME is the most common cause of vision loss in people with diabetic retinopathy. Poor blood sugar and additional medical conditions, such as high blood pressure, increase the risk of blindness in people with DME. DME can occur at any stage of diabetic retinopathy, although it is more likely to occur later as the disease progresses.

Experts estimate that about 7.7 million Americans have diabetic retinopathy, and of these, about 750,000 also have DME. A recent study suggests that non-Hispanic African Americans are three times more likely to develop DME than non-Hispanic Caucasians, most likely due to the higher incidence of diabetes in the African American population.

Eye surgery

Macular edema can develop after any type of surgery performed in the eye, including surgeries for cataracts, glaucoma, or retinal disease. A small number of people who have undergone cataract surgery (experts estimate only 1-3 percent) can do it within a few weeksthe surgery develop macular edema. If one eye is affected, there is a 50 percent chance that the other eye will also be affected. Macular edema after eye surgery is usually mild, short-lived, and responds well to eye drops that treat inflammation.

Age-related macular degeneration

Age-related macular degeneration (AMD) is a disease characterized by deterioration or breakdown of the macula, which is responsible for sharp central vision. In neovascular AMD, also called "wet" AMD, blood vessels begin to grow from the choroid (the bed of blood vessels below the retina) to the retina. These new and abnormal blood vessels leak fluid into the macula and cause macular edema.

Blockage of retinal blood vessels

When retinal veins are blocked (retinal vein occlusion), blood does not drain properly and leaks into the retina. If it leaks into the macula, macular edema develops. Leakage is made worse by the severity of the blockage, the number of veins, and the pressure in them. Retinal venous occlusion is most commonly associated with age-related atherosclerosis, diabetes, high blood pressure, and eye conditions such as glaucoma or inflammation.

Inflammatory diseases affecting the retina

Uveitis describes a group of inflammatory diseases that cause swelling in the eye and destroy eye tissue. The term "uveitis" is used because the diseases most often affect a part of the eye called uvea. However, uveitis is not limited to the uvea. Uveitis can affect the cornea, iris, lens, vitreous humor, retina, optic nerve, and whites of the eyes (sclera).

Inflammatory and immune system disorders can also affect the eye and cause swelling and breakdown of tissue in the macula. These conditions include cytomegalovirus infection, retinal necrosis, sarcoidosis, Behçet's syndrome, toxoplasmosis, Eales disease, and Vogt-Koyanagi-Harada syndrome.

How does my eye doctor check for macular edema?

To diagnose macular edema, your eye care professional will perform a thorough eye exam and look for abnormalities in the retina. The following tests can be performed to determine the location and extent of the disease:

Visual acuity test. A visual acuity test is a common way of identifying vision loss and can help diagnose vision loss due to macular edema. This test uses a standardized card or card with rows of letters that get smaller from top to bottom. If you cover one eye, you will be prompted

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