Macular edema

A macular edema , engl. (cystic) macular edema , is an accumulation of extracellular fluid ( edema ) in the area of the yellow spot ( macula lutea ) of the human eye. The reversible change manifests itself in the blurring of the visual field in the area of the zone of sharpest vision.

Emergence

The water retention under or in the pigment epithelium of the retina causes a circumscribed swelling and vesicle-like accumulations of water, which are visible when the fundus is reflected.

Possible causes are inflammation ( retinitis , uveitis ), vascular damage in the case of diabetes mellitus in the course of diabetic retinopathy, or congestion due to retinal veins occluding. Macular edema can also occur after surgery on the eye.

The cystoid macular edema after cataract extraction is also known as Irvine-Gass syndrome .

Staging

A distinction is made in four stages: focal, clinically significant (threatening visual acuity), diffuse and ischemic macular edema.

therapy

Various active ingredients are currently under development, including ruboxistaurine based on a bisindolyl maleimide . In the context of diabetes mellitus, an optimization of the metabolism can halt the course of the disease. In the case of focal macular edema, laser photocoagulation can prevent further deterioration in vision. Arterial hypertension needs treatment; There is no evidence of the advantage of certain substance groups of antihypertensive drugs.

Individual evidence

↑ Anselm Kampik, Franz Grehn: Ophthalmologic differential diagnosis - macular edema. Georg Thieme Verlag, 2008, ISBN 978-3-13-118622-5 , pp. 207 ff.
↑ W. Lüllwitz: To the clinic of the Irvine-Gass syndrome doi : 10.1007 / 978-3-642-47089-9_108
^ SR Irvine: A newly defined vitreous syndrome following cataract surgery. In: American journal of ophthalmology. Vol. 36, No. 5, May 1953, pp. 599-619, PMID 13040458 .
^ MO Tso: Pathology of cystoid macular edema. In: Ophthalmology. Vol. 89, No. 8, August 1982, ISSN 0161-6420 , pp. 902-915, PMID 7133637 , doi: 10.1016 / S0161-6420 (82) 34698-9 .
↑ MM Nentwich, MW Ulbig: Diabetic Retinopathy. In: The Diabetologist. Vol. 6, No. 6, September 2010, ISSN 1860-9716 , pp. 491-502, doi: 10.1007 / s11428-010-0605-8 .

[1] Anselm Kampik, Franz Grehn: Ophthalmologic differential diagnosis - macular edema. Georg Thieme Verlag, 2008, ISBN 978-3-13-118622-5 , pp. 207 ff.

[2] W. Lüllwitz: To the clinic of the Irvine-Gass syndrome doi : 10.1007 / 978-3-642-47089-9_108

[3] SR Irvine: A newly defined vitreous syndrome following cataract surgery. In: American journal of ophthalmology. Vol. 36, No. 5, May 1953, pp. 599-619, PMID 13040458 .

[4] MO Tso: Pathology of cystoid macular edema. In: Ophthalmology. Vol. 89, No. 8, August 1982, ISSN 0161-6420 , pp. 902-915, PMID 7133637 , doi: 10.1016 / S0161-6420 (82) 34698-9 .

[5] MM Nentwich, MW Ulbig: Diabetic Retinopathy. In: The Diabetologist. Vol. 6, No. 6, September 2010, ISSN 1860-9716 , pp. 491-502, doi: 10.1007 / s11428-010-0605-8 .