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, lesions of the macula in one of the eyes can not be noticed right away, since macular edema of the eyes is painless, and a visual defect in one of the eyes is compensated by the excellent vision of the second. In this regard, one must be attentive to oneself so as not to lose time for successful therapy with absolute restoration of vision.
Let's figure out what it is - OCT of the retina. In what cases is appointed?
Disease Description
In this case, we are talking about edema of the central region of the retina, which is called the macula or, in other words, the macula. It is this portion of the retina that is responsible for human vision. Macular edema is not an independent disease, but a symptom that is observed with a number of eye pathologies. For example, it is observed with retinopathy, and in addition, if the patient has retinal thrombosis. Macular edema can occur due to eye injuries 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 from the bloodstream into the intercellular space. 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. An increased amount of glucose contributes to damage to the vascular walls, while angiopathy develops. Thus, favorable conditions are created for the ingress of fluid from the bloodstream into the retinal tissue. In addition, with diabetes, newly formed vessels, whose walls are initially permeable and inferior, can grow into the retina.
Diabetic edema as a complication of diabetes often develops when there is not enough control over the increase in the amount of glucose in the blood, and the disease is delayed 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 choroid of the eyes.
- The development of cytomegalovirus retinitis, which is an inflammatory process in the retina that 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.
- The presence of a major aneurysm, that is, a 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 reasons for the development of the disease
Edema of the macula of the eye can occur immediately after extensive and complex manipulations, and in addition, after less traumatic surgery. The reasons are usually as follows:
- An operation to remove cataracts, followed by the installation of an artificial lens.
- Laser coagulation and cryocoagulation of the retina.
- Laser capsulotomy.
- Performing through corneal grafting, in another way keratoplasty.
- Scleroplasty and operations to improve fluid outflow in the presence of glaucoma.
Postoperative complications that cause pathology often go away without consequences and spontaneously.
Causes of the disease: injuries and side effects
Against the background of eye contusion, microcirculation disorders in the retina may occur, which lead to the development of edema. After a penetrating eye injury, edema can develop on the background of trauma, and in addition, as complications of surgical therapy.
Side effects from taking certain medications also often cause swelling. This condition is also known as toxic maculopathy. For example, medications that are based on prostaglandins can cause macular edema, along with niacin, some diabetes medications, and immunosuppressants. Therefore, you need to remember the medicines that you have to take in order to subsequently be able to answer doctor's questions in detail and quickly establish the causes of the problem. The reasons for the appearance 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.
- The presence of age-related macular dystrophy of the retina.
- The presence of central serous chorioretinopathy.
- The effect of radiation.
- Macular edema often acts as a complication of radiation treatment of cancer.
Symptoms of the disease
Symptoms of this disease are the following manifestations:
- A cloudy spot that makes it difficult to see the details of the image.
- Within the vision, there may be areas of distortion, and at the same time blurring lines.
- The image in front of the eyes may have a pink tint.
- The presence of increased sensitivity to light.
- Decreased visual acuity near and far.
- The presence of cyclicity in reducing visual acuity, usually the condition worsens in the morning.
Diagnostics
How is fundus examination done?
The specialist is diagnosed immediately after he evaluates the information obtained by interviewing the patient in aggregate and conducts all necessary examinations. The doctor may suspect pathology in the following cases:
- In the presence of characteristic complaints.
- In the presence of concomitant diseases that could serve as the basis for the development of such edema, for example, diabetes and so on.
- Decreased vision that cannot be corrected with glasses.
As part of the diagnosis, the fundus is examined and the field of view is checked. A feature of the disease is a significant deterioration in central vision, while maintaining peripheral. There are various techniques that a doctor can use to detect central vision impairment. The most informative technique is computer perimetry. Thanks to it, areas of deterioration in the clarity of vision, which are called central scotomas, are identified. The characteristic position of the scotoma may indicate damage to the area of the macula.
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 achieve the best view of the macula.
Perform fluorescence angiography
When using this technique, using a special dye, establish the area in which fluid flows from the bloodstream due to increased permeability of the vascular wall. Thanks to this technique, the place of fluid accumulation in the retinal tissues is detected, that is, it is possible to see edema with its size and boundaries.
For the diagnosis of vision, you can contact the clinic named after Fedorov. This medical facility is in many large cities.
Performing Optical Coherence Tomography
This technique (it is also abbreviated as OCT of the eye) allows you to scan the retina, determining its thickness, including the ability to examine the macular region. This technique provides the largest amount of information compared to other diagnostic methods.
What is OCT of the retina of the eye, not everyone knows. This is the latest technology, thanks to which it is possible to study the tissues of the eye thoroughly, while doing no harm.
In this diagnostic method, the effect is non-contact, since only a laser beam or infrared light is used during the procedure.
The result of OCT of the eye is a fundus image, two- or three-dimensional.
Pathology treatment
The main goal of treating 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.
Medicines that are advisable to use in this case are mainly eye drops, and in addition, various pills. Often, anti-inflammatory drugs are used in the treatment along with diuretics and microcirculators. 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 to 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 medicine as close to the macula as possible. To do this, inject the drug directly into the eye. Such a procedure requires sterile conditions, and in addition, good practical training of a doctor, therefore, it is performed by an ophthalmic surgeon in the operating room under anesthesia. Corticosteroids can also be used for treatment. These are drugs that have a powerful anti-inflammatory effect, they are able to relieve tissue swelling.
Laser retinal coagulation in the clinic named after Fedorov is carried out in order to reduce edema in the region of the macula. 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 edema in the macula is present in both eyes, then coagulation is usually carried out on one eye, and after a few weeks on the other.
Surgery as an effective treatment
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 from the eyeball region.
Therapy 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 edema of the macula, vision in patients is usually completely restored. But in the case of a long-existing edema, irreversible structural disturbances in 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.