The eye is made up of several different parts. One of these parts is the retina, which is home to special nerve cells that respond to light. The macula is part of that network and is located in the center of the retina. It is an important component that allows us to receive the best visual sharpness possible, giving us a clear center of vision.
Occasionally the macula will fill with fluid and become swollen as a result. When any tissue swells with fluid, that condition is referred to as edema. When the macula in particular becomes swollen with fluid, the fluid usually forms in a cyst-like pattern. This is thus referred to as cystoid macular edema.
Cystoid Macular Edema Causes
Cystoid macular edema has several known causes, including:
- Eye surgery, cataract surgery, or detached retina treatments
- Macular degeneration due to age
- Blockage in the veins of the retina
- Inflammation
- Injury
- Medication side effects
There are additional causes of cystoid macular edema, too, including retinitis pigmentosa, diabetes, and uveitis.
Retinitis pigmentosa
Retinitis pigmentosa refers to a group of rare eye diseases that cause deterioration in the cells within the retina, leading to vision loss. These diseases are genetic, and symptoms usually begin in childhood.
Diabetes
Diabetic macular edema (DME) can lead to vision loss in diabetic patients, with severity ranging from a lack of symptoms to significant vision loss. It can be identified by its symptoms, which include retinal thickening of the foveal center.
Uveitis
Uveitis refers to inflammation that occurs within the eye as the immune system fights an infection. This may be a result of your immune system fighting an infection of the eye or the immune system mistakenly targeting healthy tissues in the eyes. Commonly, uveitis causes symptoms like pain, vision loss, and redness.
Primary Risk Factor for Cystoid Macular Edema
Cataract surgery is the main risk factor for developing cystoid macular edema. In fact, around 1% to 3% of patients who have had their cataracts extracted will experience vision loss due to this condition.
Additionally, those who have this disorder affecting one eye have an increased risk of it occurring in the second eye as well. Despite this risk, most patients given treatment and observation will recover their vision.
Cystoid Macular Edema Symptoms
The main symptoms of cystoid macular edema are blurred vision and/or vision that decreases over time. There are a few other symptoms that may appear as well:
- Objects appear wavy when you are looking straight ahead.
- Objects appear to be different sizes from one eye to the other.
- Colors seem dull or faded.
Symptoms may go unnoticed at first, especially if cystoid macular edema is only affecting one eye. You may also only experience slightly blurred vision and no other symptoms. You may also experience more severe central vision loss. This will depend on the severity of your condition.
Diagnosing Cystoid Macular Edema
There are three ways to diagnose cystoid macular edema:
- Optical coherence tomography, or OCT: OCT is one of the best methods of diagnosing cystoid macular edema. This diagnostic method is non-invasive and uses a special light to develop a high-resolution, cross-sectional image of the tissues in question, including the retina, to determine whether cystoid macular edema is present.
- Dilated retinal exam: A special lens is used to view the macula and identify any present cysts. Your doctor may be able to diagnose cystoid macular edema using this method, but it may also go undiagnosed.
- Fluorescein angiography: This diagnostic test uses a special camera system that can detect any leakage that has resulted from blood vessels, as well as any hint of cystoid macular edema.
Cystoid Macular Edema Treatment
Cystoid macular edema prognosis is generally good. The treatment you receive for cystoid macular edema will depend on its cause. Swelling of the retina is most commonly treated with eye drops that help to reduce swelling. In more severe cases, your doctor may suggest medication injections, surgery, or laser treatment in an effort to reduce swelling.
Surgical eye treatment involves laser photocoagulation, which coagulates tissue using a strong light source. The treatment of diabetic macular edema (DME) involves a vitrectomy, which is shown to improve the resolution of edema in those who have DME. For cystoid macular edema caused by inflammation, nonsteroidal anti-inflammatory drugs would be used instead.
It’s important to consult with your primary doctor if you suspect that you have cystoid macular edema. They are the only ones who can recommend the correct treatment, though they may also refer you to a retina specialist.
Your doctor will be able to identify the underlying cause of cystoid macular edema. Knowing the cause will then help in effectively treating the condition. Successful treatment may take time but, fortunately, visual acuity improves in most cases following treatment.
Annual visits to your doctor may be required upon successful treatment of this condition. This will help to ensure that the cystoid macular edema does not return.