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Writer's pictureAtanas Bogoev M.D. and Maria Cholakova

Macular Edema Remedies: Review of Evidence-Based Treatment

Macular edema can impact visual acuity and quality of life. Timely and appropriate treatment is crucial to managing this eye condition effectively. Luckily, in recent years, we see many treatment options and macular edema remedies. They range from pharmacological interventions to surgical procedures.


Read more about what macular edema is, what causes it, and how you can treat it.


Table of Content:

4.1. Vitrectomy


Macular Edema Explained


Macular edema is a common and potentially sight-threatening condition. It affects the center part of the retina (a.k.a. macula). The condition causes fluid accumulation in the macular region. Leading to swelling and vision distortion.


Many underlying conditions cause macular edema. For instance, diabetes, diabetic retinopathy, age-related macular degeneration, uveitis, epiretinal membrane and retinal vein occlusion. The good news is, that several macular edema treatment options have become available.


Macular edema remedies range from pharmacological to surgical approaches. Here we aim to provide a comprehensive overview of treatment options. Including medical, laser, and surgical interventions.


Macula, retina, OCT
Optical Cohenrence Tomography (OCT) Image of the central retina (Macula) of a normal, helathy patient
Optical coherence tomography macular edema
Optical coherence tomography image of the central retina, demonstrating macular edema due to neovascular macular degeneration. You can see an area of atrophy of the retinal pigment epithelium (white arrow) and another area with subretinal fluid (blue arrow)

Medical Macular Edema Remedies


Anti-VEGF (Vascular Endothelial Growth Factor) Therapy


Intravitreal injections of anti-VEGF agents have become the cornerstone of macular edema treatment. These agents work by blocking VEGF, a protein that promotes abnormal blood vessel growth and leakage in the retina.


Many clinical trials have demonstrated the efficacy of anti-VEGF therapy. Specifically in improving visual acuity as well as in reducing macular edema in diabetic retinopathy, retinal vein occlusion, and uveitis.


Corticosteroids


Intravitreal corticosteroids are also a reliable medical treatment option for macular edema. Corticosteroids for macular edema treatment work by reducing inflammation and suppressing immune response. Which reduces macular edema in certain cases.


Yet, using corticosteroids as macular edema remedies carries potential risks. Some of the risks are increased intraocular pressure, cataract formation, and infection. For that reason, you should consult your eye doctor before taking corticosteroid medications. Also, ensure they can track your treatment process.


Other Pharmacological Agents


Nonsteroidal anti-inflammatory drugs (NSAIDs) and combination therapies have been widely explored for macular edema treatment, too.


NSAIDs work with other macular edema remedies to reduce inflammation and improve outcomes. Combination therapies also have potential synergistic effects.


Laser Macular Edema Treatment


Focal/Grid Laser Photocoagulation


Laser photocoagulation, using a focal or grid pattern, could be an effective macular edema remedy in certain cases. There are two types of therapy:

  • Focal laser photocoagulation uses laser energy to treat specific macula leakage areas.

  • Grid laser photocoagulation involves a wider application of laser energy to the macula.

Here is how it works. Laser photocoagulation creates small burns on the retina. These burns seal leaking blood vessels and reduce fluid accumulation.


The procedure carries potential risks, including scarring and damage to healthy retinal tissue. Its use has become less prevalent with the development of anti-VEGF therapy.


Panretinal Photocoagulation (PRP)


PRP is a common laser treatment for diabetic retinopathy. Meanwhile, it is also effective for macular edema resulting from retinal vein occlusion.


The procedure applies laser energy to the peripheral retina. The goal is to reduce abnormal blood vessel growth and leakage. This can indirectly improve the macular edema condition.


Then again, panretinal photocoagulation may also have potential side effects in some cases. For example, peripheral vision loss and night vision disturbances.


Surgical Macular Edema Remedies


Vitrectomy


Vitrectomy is a surgical procedure involving the removal of the vitreous gel from the eye. Surgical treatment is an option in cases of macular edema that is caused by a membrane on top of the retina (epiretinal membrane) and does not respond to medical or laser treatments.

Optical coherence tomography of the center of the retina demonstrating a membrane on top of the retina with retinal folds and swelling.
Optical coherence tomography of the center of the retina demonstrating a membrane on top of the retina with retinal folds and swelling.

Vitrectomy alleviates traction on the macula, removes scar tissue, and improves fluid drainage. Thus, there is a reduction in macular edema and visual acuity improvement.


Even so, vitrectomy is an invasive procedure. There are some potential risks, including infection, bleeding, and retinal detachment. Unlike other macular edema remedies, this procedure is a last resort.


In conclusion...


Macular edema is a challenging eye condition that impacts visual function. The right choice of macular edema treatment depends on the:

  1. Underlying cause

  2. Severity of the condition

  3. Individual patient's characteristics


Regular follow-up and monitoring are essential to assess remedy response. And the eye doctor could adjust the macular edema treatment plan.


For more eye health and eye care content, read the Ophthalmology24 blog section for patients.

Resources:

All medical facts are checked by Atanas Bogoev M.D.

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