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  MACULAR EDEMA  
 

 

  • Because of failure of RPE cells edema occurs in the eye.
  • Macular edema comprises:-
    • Cystoid Macular Edema (CME)
    • Neovascularisation
    • Diabetic Edema

CME
It is called CME because, it occurs in the macula and forms cyst like spaces in the retinal tissue.

Etiology

  • Vasculature and Inflammatory diseases
  • Extracellular accumulation of fluid.

Symptoms

  • Visual impairment
  • Metamorphopsia
  • Flickering
  • Macropsia/Micropsia

          

Diagnosis

  • Slit lamp examination
  • FFA - Fluorescein angiography images show your Eye M.D. if any blood vessels are leaking and how much leakage there is.
  • OCT - Because macular edema occurs inside the layers of retina tissue, you may have a test called fluorescein angiography, or another called optical coherence tomography (OCT) to help make an accurate diagnosis.
  • It measures the thickness of the retina and is also very sensitive at detecting swelling and fluid.

                              


           

Treatment

  • Preventive
  • Medical
  • Surgical

Preventive Treatment

  • Keep underlying Systemic diseases well Controlled-
    • DM
    • HIV/CMV
    • BP/Lipid control

Medical Treatment

  • Topical Therapy – NSAIDS, Steroids
  • Systemic Therapy-NSAIDS, Steroids, Diuretics
  • Unique Posterior Segment Drug Delivery
    • Trans-scleral
    • Intravitreal – ( Kenalog, Macugen,Lucentis, Avastin)
    • Injection
    • Implant (Biodegradable / Nonbiodegradable)

            

Surgical Treatment

  • Nd:YAG vitreolysis
  • Pars Plana Vitrectomy/Membrane Peel
  • Focal/Grid Photocoagulation
  • Photo-Dynamic Therapy (PDT)