Cystoid Macular Edema

Cystoid Macular Edema is a painless eye disorder that affects the central part of the back surface of the eye, macula, causing it to swell with fluid. This fluid combines in the macula in the form of cyst-like formations (cystoid) resulting in swelling or edema.

The macula is responsible for the majority of the central field of view and is the most critical area for visual acuity (sharpness). As such, CME affects detailed vision that helps you see faraway objects, fine detail and color.

Symptoms of Cystoid Macular Edema

In its earliest stages, Cystoid Macular Edema (CME) is generally asymptomatic meaning patients will hardly portray or detect any symptoms. As the condition progresses, patients may experience, among others, the following symptoms.

• Wavy or blurred central vision: straight lines might appear wavy, darker, or non-existent.
• Difficulty reading
• Distortion of colors: colors may appear to have hints of pink
• Loss of contrast sensitivity
• Light sensitivity

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Causes of Cystoid Macular Edema

Although researchers have yet to pinpoint the exact cause of Cystoid Macular Edema, they believe you are more likely to develop CME if you have had:

• Eye surgery, including cataract surgery and repair of a detached retina
• Diabetes (diabetic retinopathy)
• Age-related macular degeneration (AMD)
• Inflammation of the eye
• Retinal vein occlusion, a blockage in veins of the retina
• Injury to the eye
• Side effects of medication

Risk Factors of Cystoid Macular Edema

Some of the common risk factors associated with cystoid macular edema are:

• Eye surgery. Approximately 30 percent of patients who undergo eye surgery, particularly cataract surgery and repair of a detached retina, develop CME within a few weeks, months or even years after the surgery.
• Metabolic conditions, particularly diabetes
• Blood vessel diseases, particularly vein occlusion/blockage
• Aging. Age-related macular degeneration is a reality for everyone older than 60.
• Inflammatory conditions such as uveitis and sarcoidosis
• Traction on the macula, specifically macular pucker, macular hole, and vitreomacular traction

Diagnosis of Cystoid Macular Edema

Eye-care professionals turn to a few tests to diagnose Cystoid Macular Edema. Three key exams are:

• Dilated Retinal exam
• Fluorescein angiography
• Optical coherence tomography (OCT)

Dilated Retinal exam

Your doctor may diagnose CME using a special lens to assess the macula look for and identify any cysts present.

Fluorescein Angiography

This is a diagnostic test that uses a special camera system to look for and identify any leakage that results from blood vessels and the associated cystoid edema of the macula.

Optical Coherence Tomography (OCT)

This is one of the most reliable ways to diagnose and identify cystoid macular edema. It is a non-invasive test that makes use of a special light to create high-resolution cross-sectional images of the tissues under assessment, including the retina.

This test provides very detailed images of the thickness of the macula and helps your doctor find leakage and measure swelling of the macula. It can also be used to monitor response to treatment.

Treatment Options for Cystoid Macular Edema

Although there is no definitive cure for CME, eye doctors engage various treatment options to manage the condition. The treatment of choice depends on the cause of the condition, its severity and the circumstances of each patient.

Only an eye doctor can recommend the right treatment for someone with CME, which may also require the input of a retina specialist.

The first step to treatment is to identify the root cause of the condition for each individual patient and addressing it. Once this is done, your doctor may recommend any of these treatment options to deal with the related swelling and swelling, including:

• Topical NSAIDs. Non-Steroidal Anti Inflammatory Drugs (NSAIDs) can be given as ocular eye drops to cure the swelling.
• Steroid treatment. If inflammation is the cause of CME, steroids may be prescribed either as tablets, ocular eye drops, or as ocular injections (injections into the eye).
• Intravitreal injections. Anti-Vascular Endothelial Growth Factor (Anti-VEGF) medication administered as intravitreal injections into the eye can slow the growth of abnormal blood vessels in the retina and reduce leakage from blood vessels.
• Laser treatment. With this treatment, tiny pulses of high-energy light are applied to the areas of fluid leakage around the macula to seal off the leaking blood vessels and stabilize vision.
• Vitrectomy surgery. When vitreous pulling on the macula is the cause of macula edema, vitrectomy may be required. Vitrectomy is a procedure that restores the macula to its normal shape (lying flat).

Frequently Asked Questions on Cystoid Macular Edema

What does cystoid macular edema mean?

Cystoid Macular Edema (CME) is a painless eye disorder that affects the central part of the back surface of the eye, macula, causing it to swell with fluid. This fluid combines in the macula in the form of cyst-like formations (cystoid) resulting in swelling or edema. CME affects detailed vision that helps you see faraway objects, fine detail, and color.

What causes cystoid macular edema?

The exact cause of cystoid macular edema is not known. However, you are more likely to have CME if you have had any or several of the following contributing conditions:

• Eye surgery, particularly cataract surgery and repair of a detached retina
• Diabetes or diabetic retinopathy
• Age-related macular degeneration (AMD)
• Inflammation of the eye
• Retinal vein occlusion, a blockage in veins of the retina
• Injury to the eye
• Side effects of medication

Can CME be cured?

Unfortunately, cystoid macular edema cannot be cured. However, this condition can be effectively treated if diagnosed early. Many treatment options are available depending on the cause of the condition, its severity, and the individual patient’s circumstances. With continued treatment, normal vision may return.

References

1. Cystoid Macular Edema. (October 2014). American Academy of Ophthalmology.

2. Cystoid Macular Edema. (March 2015). Cleveland Clinic.

3. Cystoid macular edema. (December 2008). Clinical Ophthalmology.