What Is the Best Treatment for Macular Edema?

Medically Reviewed on 3/30/2021

Macular edema is a type of swelling inside the retina of the eye. The best approach to treatment requires addressing the underlying cause of macular edema, and it may include injections, steroids, eye drops, laser treatment and vitrectomy surgery.
Macular edema is a type of swelling inside the retina of the eye. The best approach to treatment requires addressing the underlying cause of macular edema, and it may include injections, steroids, eye drops, laser treatment and vitrectomy surgery.

Macular edema is a type of swelling inside the retina of the eye.

The best approach to treatment requires addressing the underlying cause of macular edema, and it may include

Medication injections: These are the mainstay for advanced macular edema.

  • There are medications called anti-vascular endothelial growth factor (anti-VEGF) drugs, for example, Avastin (bevacizumab).
  • Anti-VEGF treatment reduces the abnormal blood vessels in the retina and leaking from the blood vessels.
  • This medicine is delivered to your eye through a very slender needle.

Steroid treatment

  • When macular edema is caused by inflammation, a steroid medication may be used.
  • These drugs can be given by eye drops, pills or injections.

Eye drops medication

  • To prevent macular edema, which can occur after cataract surgery, an ophthalmologist may prescribe nonsteroidal anti-inflammatory eye drops for a few months.

Laser treatment

  • With this surgery, an ophthalmologist applies many tiny laser pulses to the areas of fluid leakage around the macula.
  • The goal is to stabilize vision by sealing off the leaking blood vessels.

Vitrectomy surgery

  • A procedure called a vitrectomy may be needed to restore the macula to its normal (lying flat) shape.
  • The surgeon uses tiny instruments to remove the vitreous from the eye and peel the scar tissue from the macula.
  • This relieves the traction that is damaging the macula.

Depending on the cause of macular edema and treatment plan your doctor has recommended, macular edema may take several months to resolve. During this time, it is important to follow the treatment regimen that your ophthalmologist recommends for your treatment to be effective.

What is macular edema?

Macular edema occurs when fluid and protein deposits are collected on or under the macula of the eye (a yellow central area of the retina) and cause it to thicken and swell (edema). The swelling may distort central vision. Macular edema is painless and usually doesn’t have symptoms in the initial stages. Do not ever ignore any sign that the blood vessels in your eye may be leaking. Common symptoms of macular edema include

  • Blurred or wavy central vision
  • Colors appear washed out or different
  • Having difficulty reading

If untreated, this can lead to permanent damage and even death of these cells. See an ophthalmologist as soon as possible. If left untreated, macular edema can cause significant loss of central vision, although peripheral (side) vision normally remains intact.

Macular edema is not a disease itself, but is more likely a result of other diseases or eye trauma that cause fluid to build up in the macula and make it swell. Common causes include

  • Diabetes: High blood sugar levels weaken blood vessels causing them to leak into the macula.
  • Macular degeneration: This is a common cause of sight problems as we get older. Age-related macular degeneration comes in two forms, namely, wet and dry.
  • Hereditary/genetic conditions: A common example of this would be retinitis pigmentosa.
  • Inflammatory eye diseases: Anything that causes inflammation and swelling in the eye can affect the macula, for example, uveitis.
  • Surgery: Macular edema may occur as the result of cataract, glaucoma or retinal surgery.
  • Medicines: You must alert your optometrist about any medications you are taking because some can have side effects that cause macular edema.
  • Other conditions: These may include blockage in the small veins of the retina, injuries to the eye and some eye tumors.

Rarely, macular edema will go away on its own. However, if you have symptoms of macular edema, you must see an ophthalmologist right away. The prognosis is very variable in each situation. In all cases, it is advisable to consult an ophthalmologist who specializes  in retinas to make an accurate diagnosis and provide the most convenient treatment. Macular edema may take several months to resolve. During this time, it is important to follow the treatment regimen that your ophthalmologist recommends for your treatment to be effective.

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Medically Reviewed on 3/30/2021
References
Medscape Medical Reference

National Eye Institute