Cystoid macular oedema is a vision disorder that affects the central portion of the retina, called the macula. “Oedema” occurs when the tissues become swollen with fluid, and if it is located in the macula, the fluid pools into cyst-like areas. Chronic oedema can cause permanent damage. However, most people are able to recover clear, sharp vision with prompt professional intervention and appropriate treatment.
The medical professionals best qualified to evaluate, diagnose and treat cystoid macular oedema are ophthalmologists with extensive training in diseases and surgery of the retina and vitreous. Known as retina specialists, they have unique expertise in the advanced technology and equipment used to treat problems like macular oedema.
What Causes Cystoid Macular Oedema?
Most cases of cystoid macular oedema develop after cataract surgery; between 1 and 3 percent of cataract surgery patients develop cystoid macular oedema. It can also appear after surgery to repair a detached retina, or as the result of another health issue such as uveitis, age-related macular degeneration or diabetes. Some cases are caused by inflammation in the eye or an eye injury.
Cystoid macular oedema can cause a decrease in central vision (peripheral vision is unaffected), or it may cause blurriness or waves in the middle of the field of view. It can also distort the appearance of colors or reduce contrast sensitivity. If one eye develops cystoid macular oedema, there is a risk of up to 50 percent that the second eye is affected.
Some cases of cystoid macular oedema are asymptomatic, meaning they do not cause any symptoms.
Cystoid macular oedema can be diagnosed a few different ways. The ophthalmologist can perform a dilated retinal exam and use a special lens to look at the macula and identify any cysts. A test called a fluorescein angiography can be used to look for leakage from blood vessels and associated swelling. Or, a test called optical coherence tomography may be performed; this involves a special light that captures high-resolution cross-sectional images of the macular and retinal tissues.
Treatment Options for Cystoid Macular Oedema
Treatment options vary, and are chosen based on the origin of the problem. After evaluating the individual case and ascertaining the root of the swelling, the retina specialist makes their recommendations. Currently cystoid macular oedema can be treated with topical drugs, injections or surgery.
Inflammation in the retinal tissues can be treated with non-steroidal anti-inflammatory medications. These drugs may be administered through eye drops. If they do not work, steroid drops may be recommended. Or, more powerful steroids can be injected around or inside the eye to stop the swelling and irritation. Diuretics may also be prescribed to help lessen swelling, in some cases.
Injections of anti-vascular endothelial growth factor (VEGF) agents may be used in cases of cystoid macular oedema. VEGF is a chemical that triggers the growth of blood vessels. Anti-VEGF drugs are designed to limit the growth of these abnormal blood vessels and slow their leakage. Injection therapy is typically performed in an office setting with local anesthetic.
If the vitreous fluid is pulling on the macula and causing swelling, surgery to clear some or all of the vitreous gel can help. This procedure, known as vitrectomy, replaces the natural vitreous with a saline liquid to fill the inner chambers of the eye.