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Macular Edema

What is Macular Edema?

Macular edema is the build-up of fluid in the macula, an area in the center of the retina. The retina is the light-sensitive tissue at the back of the eye, and the macula is the part of the retina responsible for sharp, straight-ahead vision. Fluid build-up causes the macula to swell and thicken, which distorts vision.

Macular edema occurs when there is abnormal leakage and accumulation of fluid in the macula from damaged blood vessels in the nearby retina. A common cause of macular edema is diabetic retinopathy, a disease that can happen to people with diabetes. Macular edema can also occur after eye surgery, in association with age-related macular degeneration, or as a consequence of inflammatory diseases that affect the eye. Any disease that damages blood vessels in the retina can cause macular edema.


  • Blurry or wavy vision near or in the center of your field of vision
  • Colors appearing washed out or faded

If only one eye is affected, you may not notice your vision is blurry until the condition is well-advanced.

Risk Factors

Anyone with type 1 or type 2 diabetes is at risk for developing diabetic macular edema (DME) or diabetic retinopathy. Specific risk factors include:

  • Duration of diabetes — the longer you have diabetes, the greater your risk of developing diabetic macular edema (DME)
  • Chronic high levels of blood sugars
  • High cholesterol levels
  • Hypertension (high blood pressure)
  • Kidney disease
  • Heart disease
  • Smoking
  • Pregnancy


Diabetic macular edema (DME) and diabetic retinopathy rarely have visual symptoms in their early stages. That is why it is important for all diabetics to have a comprehensive eye exam every year. In addition, diabetics should continually monitor and work to lower their risk factors, including blood pressure, blood sugar levels and cholesterol levels. Adopting a healthy lifestyle, including proper diet, exercise and not smoking, is also important.


Your Texas Retina physician will dilate your pupils and examine your retina. Since macular edema occurs inside the retina, your doctor may also conduct additional tests to make an accurate diagnosis, including:

Fluorescein Angiography (FA)

In this test, a small amount of vegetable-based dye is injected into a peripheral vein, usually in the arm. This dye lights up the retina’s vascular network so detailed images can be taken. These images can indicate whether any blood vessels are leaking and how much leakage there is.

Optical Coherence Tomography (OCT)

In this non-invasive test, a special camera is used to photograph your retina. It measures the thickness of the retina and can also detect any swelling or fluid.


One of the first treatment strategies for macular edema is to address any underlying causes like diabetes or high blood pressure. Then, to directly treat any damage to the retina, the current standard of care is an intravitreal injection to block the activity of a substance called vascular endothelial growth factor (VEGF).

In macular edema, VEGF is overactive, causing the growth of blood vessels that can rupture and leak into the retina and macula. When injected into the eye, anti-VEGF medications like Avastin, Eylea and Lucentis, help to block this activity and slow the progression of the disease. During the injection, numbing drops are applied to the eye, and a short thin needle is used to inject medication into the vitreous gel — the fluid in the center of the eye.