Foveal Macular Edema Treatments

Located in the foveal region of the retina, the macula is an important part of the visual system, responsible for clear central vision. A damaged macula means distorted vision when looking at objects straight ahead. Macular edema, one type of damage, occurs when fluid accumulates in the tissue under the macula. Causes of edema include ocular inflammation and, more commonly, complications from uncontrolled diabetes. Prompt treatment is crucial to preserving vision when macular edema occurs.

Laser Treatment
According to the Mayo Clinic, macular edema is the leading cause of decreased vision in patients with early diabetic eye complications, also called background diabetic retinopathy. Uncontrolled diabetes leads to leakage of blood vessels in the back of the eye. Fluids, such as blood and fatty lipid material called exudates, can then accumulate. This can lead to numerous complications, including swelling under the macula tissue. When this occurs, clinically significant macula edema requires treatment with a focal laser procedure, also called focal laser photocoagulation. Laser light focused on the macula targets the leaky vessels, resulting in laser scars or burns that help reduce further leakage and the amount of fluid accumulated. If laser treatment for both eyes is necessary, the treatments are usually scheduled a few weeks apart. Focal laser photocoagulation is the mainstay treatment for macular edema caused by diabetic retinopathy and, according to the National Eye Institute, reduces the chance for vision loss by 50 percent.

Anti-inflammatory Drugs
Macular edema can result from retinal inflammation. It often follows procedures such as cataract surgery. In this type of edema, cyst-like pockets of fluid build up in the macular region--hence its name cystoid macular edema--and the reason for its development is unknown. Often, steroidal anti-inflammatory eyedrops are prescribed to treat cystoid macular edema. An injection of steroids--such as cortisone--into the eye can be necessary in cases of more severe edema. According to the University of Michigan, injecting steroids intraocularly for macular edema caused by diabetes is an emerging treatment option. Repeat injections are often necessary.

Vitrectomy
The vitreous is the large, gel-like area that makes up a bulk of the back of the eye. It comes in contact with the retina and macular tissue. Sometimes tugging of the macula by the vitreous gel can lead to macular edema. When this occurs, it's recommended to have surgery to remove the vitreous gel. This procedure is called a vitrectomy. A vitrectomy is also performed when macular edema and other complications caused by diabetes result in significant blood accumulation in the vitreous. This procedure is usually recommended for advanced diabetic cases.

Preventive Care
The most serious type of macular edema is connected to diabetic retinopathy, because there is a high risk for vision loss. Therefore, doctors strongly recommend control and care of blood sugar through diet, exercise and medication. Other preventive measures include annual eye exams and controlling other diseases such as high blood pressure and high cholesterol. The National Eye Institute reports that macula edema can often occur without symptoms of blur, so preventive care is essential to detecting it before lasting damage can occur.