Macular edema is a local accumulation of fluid inside the retina in the region of the macula, or macula, that is, the area that is responsible for the clarity of vision. Thanks to the macula, people cope with sewing, reading, face recognition and the like. Despite these symptoms, macular lesions in one of the eyes may not be immediately noticeable, since the macular edema of the eyes is painless, and the visual defect in one of the eyes is compensated by the excellent vision of the other. In this regard, one must be attentive to oneself so as not to miss the time for successful therapy with an absolute restoration of vision.
Let's figure out what it is - retinal OCT. When is it prescribed?
Description of the disease
In this case, we are talking about swelling of the central region of the retina, which is called the yellow spot or otherwise the macula. This area of the retinaresponsible for human vision. Macular edema is not an independent disease, but a symptom that is observed in a number of eye pathologies. For example, it is observed with retinopathy, and in addition, if the patient has retinal thrombosis. Macular edema may occur due to eye injury or after surgery.
Causes of edema: how does it occur?
The cause of the problem is the increased permeability of the vessel walls. As a result, fluid flows out of the bloodstream into the intercellular space. The retinal tissues in the macular region increase in volume, which greatly interferes with the normal functioning of the visual receptors.
A common cause of macular edema is diabetes mellitus. An increased amount of glucose contributes to the defeat of the vascular walls, and angiopathy develops. Thus, favorable conditions are created for the entry of fluid from the bloodstream into the retinal tissues. In addition, in diabetes, newly formed vessels can grow into the retina, whose walls are initially permeable and defective.
Diabetic edema as a complication of diabetes often develops when there is insufficient control over the increase in the amount of glucose in the blood, and the disease lingers at the stage of decompensation. One of the reasons for the development of this disease can be eye infections, namely:
- Uveitis, which is a different type of inflammation of the vascular membranes of the eyes.
- Development of cytomegalovirus retinitis, which isan inflammatory process in the retina, which is caused by a viral causative agent of eye infections.
- The appearance of scleritis, that is, inflammation of the outer shell of the eyes.
Another reason is vascular problems in the form of:
- Presence of retinal vein thrombosis.
- Presence of a large aneurysm, that is, limited expansion of the central artery.
- The presence of vasculitis, that is, a genetically determined inflammatory process in the walls of blood vessels.
Eye surgery as one of the causes of the development of the disease
Edema of the macula of the eye can occur immediately after extensive and complex manipulations, and in addition, after a low-traumatic surgical intervention. The reasons are usually as follows:
- Cataract surgery followed by placement of an artificial lens.
- Carrying out laser coagulation and cryocoagulation of the retina.
- Laser capsulotomy.
- Performing penetrating corneal plasty, otherwise keratoplasty.
- Scleroplasty and surgery to improve fluid outflow in the presence of glaucoma.
Postoperative complications that cause pathology often disappear without consequences and spontaneously.
Causes of illness: injuries and side effects
Against the background of eye contusion, microcirculation disorders in the retina may appear, which lead to the development of edema. After a penetrating injury to the eye, edema may develop against the background of injury, and in addition, ascomplications of surgical therapy.
Side effects of certain medications are also often the cause of swelling. This condition is also known as toxic maculopathy. For example, macular edema can be caused by drugs that are made on the basis of prostaglandins, along with niacin drugs, certain diabetes drugs and immunosuppressants. Therefore, you need to remember the medicines that you have to take in order to later be able to answer the doctor's questions in detail and quickly determine the causes of the problem. The causes of such edema are also other intraocular pathologies:
- Hereditary diseases, such as retinitis pigmentosa.
- Various acquired pathologies in the form of an epiretinal membrane, strands between the macula and the vitreous body, which can provoke edema along with subsequent retinal detachment.
- Presence of age-related macular degeneration of the retina.
- Presence of central serous chorioretinopathy.
- The effect of radiation.
- Macular edema is often a complication of radiation treatment of cancer.
Symptoms of disease
Symptoms of this disease are the following manifestations:
- A haze that obscures the details of the image.
- Within vision there may be areas of distortion, and at the same time blurring of lines.
- The image before your eyes may have a pink tint.
- High sensitivity to light.
- Decreasevisual acuity near and far.
- Presence of cyclicity in the decrease in visual acuity, usually the condition worsens in the morning.
Diagnosis
How is a fundus examination performed?
A specialist makes a diagnosis immediately after he evaluates the information obtained during the patient's interview in the aggregate and conducts all the necessary examinations. The doctor may suspect a pathology in the following cases:
- When there are characteristic complaints.
- If there are concomitant diseases that could serve as the basis for the development of such edema, for example, diabetes and so on.
- Reduced vision that cannot be corrected with glasses.
As part of the diagnosis, an examination of the fundus and a check of the visual field are performed. A feature of the disease is a significant deterioration in central vision while maintaining peripheral vision. There are different techniques that a doctor can use to detect a violation of central vision. The most informative technique is computer perimetry. Thanks to it, areas of visual impairment, which are called central scotomas, are identified. The characteristic position of the scotoma may indicate damage to the macula region.
Fundus examination
The condition of the macula can be visually assessed using ophthalmoscopy. This technique allows you to get an idea of the general condition of the retina. Before the examination, the doctor uses drops that dilate the pupil to get the best view of the macula.
Performing fluorescein angiography
When using this technique, using a special dye, an area is established in which fluid flows out of the bloodstream due to increased permeability of the vascular wall. Thanks to this technique, the place of accumulation of fluid in the tissues of the retina is revealed, that is, it is possible to see the edema with its size and boundaries.
For vision diagnostics, you can contact the Fedorov Clinic. This medical facility is in many major cities.
Performing optical coherence tomography
This technique (also called OCT of the eye for short) allows you to scan the retina, determining its thickness, including the macular area. This technique provides the greatest amount of information compared to other diagnostic methods.
What is it - OCT of the retina, not everyone knows. This is the latest technology, thanks to which it is possible to study the tissues of the eye thoroughly, without causing harm.
In this diagnostic method, the impact is non-contact, since only a laser beam or infrared light is used during the procedure.
The result of the OCT of the eye is a picture of the fundus, two or three dimensions.
Treatment of pathology
The main goal of the treatment of macular edema is to stabilize visual function along with the elimination of increased vascular permeability. The treatment plan largely depends on the causes of the development of edema and the nature of its severity.
Medications thatit is advisable to use in this case - these are mainly eye drops, and in addition, various tablets. Often, anti-inflammatory drugs are used in the treatment, along with diuretics and agents that improve microcirculation. In the event that macular edema is caused by the progression of chronic diseases, treatment is prescribed to improve control over the development of the disease or stop further deterioration. The drug that caused the swelling is canceled or replaced with another medication.
When a more powerful therapeutic effect is required, doctors resort to bringing the drug as close to the macula as possible. To do this, the drug is injected directly into the eye. Such a procedure requires sterile conditions, and in addition, good practical training of the doctor, so it is performed by an ophthalmic surgeon in the operating room under anesthesia. Corticosteroids may also be used for treatment. These are drugs that have a powerful anti-inflammatory effect, they are able to relieve tissue swelling.
Laser coagulation of the retina in the Fedorov Clinic is carried out in order to reduce swelling in the macula area. Such a procedure can be performed, including repeatedly, in order to achieve the best control over the processes of fluid accumulation. In the event that macular edema is present in both eyes, then coagulation is usually performed on one eye, and a few weeks later on the other.
Surgery as an effective waytreatment
In cases where edema is difficult to treat, and in addition, vitrectomy is used to prevent complications of this condition. This procedure involves the removal of the vitreous body from the region of the eyeball.
Treatment of macular edema to its absolute disappearance usually takes several months (usually it takes from two to fifteen months). The only thing a patient can do to speed up the process of his recovery is to follow absolutely all medical recommendations.
In the presence of uncomplicated macular edema, vision is usually fully restored in patients. But in the case of a long-term edema, irreversible structural damage in the area of the macula may occur, which is likely to affect visual acuity. In this regard, with any suspicion of macular edema, you should not postpone your visit to the doctor.
