Macular Edema – Monitoring and Managing Treatment

Macular Edema – Monitoring and Managing Treatment

Posted on Mar.14, 2018, under Educational, Low Vision Info

Macular edema (ME) is the swelling of the macula, a tiny spot in the retina critical for clear vision. When ME is left untreated visual symptoms can become worse and permanent damage to the retina can occur.


Monitoring for Macular Edema

Knowing and recognizing the signs and symptoms of ME is important so that one can quickly contact an eye doctor to be evaluated.  However, one shouldn’t wait for symptoms or vision changes to appear to be examined.  Regular eye exams based on the recommendation of your eye doctor can alert him or her to early retinal changes or fluid build up that may occur before symptoms appear..  Home monitoring with an Amsler Grid can be an additional useful tool to identify changes in vision for early intervention.


Macular Edema Treatment Options

The treatment of macular edema depends on the underlying cause and whether it’s the result of a chronic disease like diabetes, a side effect from a surgery like cataracts, or damage to the retina like a retinal detachment. Two of the main physiological factors that affect the development of leaky, weak blood vessels and the accumulation of fluid under the macula are inflammation and growth factors such as vascular endothelial growth factor (VEGF).  When the two interact the combined interaction makes ME worse.


Anti-VEGF Injections

The most common treatment at this time is injections given directly into the eye with an anti-VEGF drug.  The purpose of the injections are to stop the weak blood vessels from leaking and to slow down the growth of these abnormal blood vessels.  There are 3 medications that work by blocking VEGF, the protein that is responsible for the abnormal blood vessel growth.  The medications that are used for  anti-VEGF therapy are aflibercept (Eylea), ranibizumab (Lucentis) and bevacizumab (Avastin) as an off label drug use.  The frequency of these injections depends on the cause, how severe the edema is, and how well one responds.


Corticosteroid Treatment

Patients who have macular edema usually have inflammation as well. Corticosteroid treatments via eye drops, pills or sustained release injections into or around the eye are often given to those with diabetic retinopathy, macular degeneration, and inflammatory diseases like uveitis.


Laser Photocoagulation

Laser treatment can stabilize vision by sealing off blood vessels that are leaking and oozing fluid.  This treatment is often used in patients with diabetic retinopathy or retinal vein occlusion.


Manage Blood Sugar Levels

Diabetics can sometimes help support better vision by controlling their blood sugar.  It is when blood glucose levels are high that damage can occur to the endothelial cells, the cells that line blood vessels.


There has been much progress in the treatment of macular edema and there will continue to be thanks to many current clinical trials that are looking at new options or new combinations of treatment.  To learn more go to Macular Edema


Leslie Degner, RN, BSN