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macular edema; retinal edema
Etiology:
- diabetic retinopathy
- central retinal vein occlusion
- hemi-retinal vein occlusion
- wet (neovascular) macular degeneration
Epidemiology:
1) most common cause of visual impairment due to diabetic retinopathy
2) may occur in proliferative or non-proliferative phase of diabetic retinopathy
Clinical manifestations:
- visual impairment
- loss of clear vision centrally (central scotoma)
- often the vision is distorted
- patients will describe letters missing in the middle of a word
Differential diagnosis:
- symptoms similar to macular degeneration
- manifestation of wet (neovascular) macular degeneration
Management:
- argon laser therapy
- ranibizumab (Lucentis) FDA-approved
- bevacizumab noninferior to aflibercept for treatment of macular edema due to central retinal vein occlusion [3]
Related
diabetic retinopathy (DR, proliferative {PDR} & non-proliferative)
macula retinae, macula lutea, macula, area centralis or punctum luteum
Specific
clinically-significant macular edema (CSME)
cystoid macular edema (CME)
diabetic macular edema (DME)
General
sign/symptom
maculopathy (macular retinopathy)
References
- Geriatrics Review Syllabus, American Geriatrics Society,
5th edition, 2002-2004; 7th edition 2010
- FDA News Release: Aug. 10, 2012
FDA approves Lucentis to treat diabetic macular edema
http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm315130.htm
- Scott IU, VanVeldhuisen PC, Ip MS et al
Effect of Bevacizumab vs Aflibercept on Visual Acuity Among
Patients With Macular Edema Due to Central Retinal Vein
Occlusion. The SCORE2 Randomized Clinical Trial.
JAMA. 2017;317(20):2072-2087
PMID: 28492910
http://jamanetwork.com/journals/jama/article-abstract/2626260
- Bressler NM
Treatment of Macular Edema Due to Central Retinal Vein Occlusion.
Another Score for Repackaged Bevacizumab.
JAMA. 2017;317(20):2067-2069
PMID: 28492939
http://jamanetwork.com/journals/jama/article-abstract/2626259