By
Jonathan Yoken, MD
CYSTOID
MACULAR EDEMA
The specialized
central zone of the retina-the macula-is extremely delicate, and
even minute alterations in shape or function can affect our ability
to see details clearly. Cystoid macular edema is the term given
to a focal accumulation of fluid (edema) at the center of the
vision (the macula), sometimes leading to the development of small
pockets of fluid (cysts) that can be seen on examination of the
retina.
CME can occur
under several conditions. Most commonly, it can develop following
cataract surgery (occurring weeks, months or even years later).
In other cases, CME can be the result of a blockage of circulation
(a branch retinal vein occlusion) or other abnormalities of the
tiny capillaries of the retina. CME can also be a consequence
of chronic inflammation of the eye (uveitis).
The evaluation
of CME typically involves a complete eye exam, followed by a detailed
photographic study of the retina (fluorescein angiography), which
can usually be performed in the doctor's office. The photographs
allow your doctor to confirm the cause of the CME, which is crucial
to deciding on a plan of treatment.
If the CME
occurs after cataract surgery or if it is due to chronic inflammation
of the eye (uveitis), a program of topical anti-inflammatory drops
is successful in improving the vision in a large percentage of
patients. If CME persists, an injection of a local anti-inflammatory
medication is often useful. In cases of CME due to leakage from
blocked or abnormal blood vessels, laser treatment may be performed
to seal the leaky blood vessels. The body then proceeds to "pump
out" the fluid and the macular edema resolves
