What is Cystoid Macular Edema (CME)?
Cystoid Macular Edema (CME) is a condition where fluid accumulates in the macula the central part of the retina responsible for sharp, detailed vision. The fluid forms multiple small cyst-like spaces between the retinal layers, leading to a thickened and swollen macula. This edema disrupts the normal retinal architecture and impairs central vision. CME does not usually cause pain but can lead to blurred or distorted central vision, difficulty reading, and faded or washed-out colors. If not properly treated, CME may result in irreversible damage to the retinal tissue and permanent vision loss.
What Causes Cystoid Macular Edema?
CME can occur due to a variety of underlying ocular or systemic conditions. It is often associated with inflammation, vascular compromise, or surgical trauma. Common causes include: Retinal vein occlusion (RVO), uveitis, diabetic retinopathy, ocular surgery (especially cataract), ocular trauma, drug-induced CME, and retinal dystrophies or epiretinal membranes.
Who is at Risk?
CME can develop in anyone, but risk is higher in individuals with diabetes, retinal vascular disorders, previous eye surgeries, autoimmune diseases, or use of certain medications.
Symptoms of Cystoid Macular Edema
CME typically develops gradually and without pain. Symptoms include blurred central vision, distorted or wavy vision (metamorphopsia), difficulty reading or recognizing faces, faded colors, and central scotomas. Peripheral vision usually remains unaffected.
Diagnosis of Cystoid Macular Edema
Diagnosis includes dilated fundus examination, Optical Coherence Tomography (OCT) for detailed retinal imaging, Fluorescein Angiography (FA) to visualize leakage patterns, and sometimes Fundus Autofluorescence or OCT Angiography (OCTA).
Treatment Options for Cystoid Macular Edema
Treatment depends on the underlying cause and includes topical NSAIDs or corticosteroids, intravitreal injections (steroids or anti-VEGF), systemic therapy, laser photocoagulation, or vitrectomy surgery. Each case requires an individualized treatment plan.
Prognosis and Follow-Up
With timely treatment, vision can significantly improve. However, chronic cases may result in residual deficits. CME may recur and requires close monitoring with OCT.
Conclusion
Cystoid Macular Edema is a sight-threatening condition but is manageable with modern diagnostics and therapies. Early recognition and individualized care are essential for preserving vision.
