About cystoid macular degeneration
What is cystoid macular degeneration?
Best vitelliform macular dystrophy is an autosomal dominant genetic form of macular degeneration that usually begins in childhood or adolescence and slowly progresses to affect central vision. The age of onset and severity of vision loss are highly variable. Best vitelliform macular dystrophy is associated with an abnormality in the VMD2 gene.
What are the symptoms for cystoid macular degeneration?
Difficulty reading symptom was found in the cystoid macular degeneration condition
Macular edema is painless and initial symptoms may not be noticeable, especially if only one eye is affected. The symptoms of macular edema include the following:
- Blurry central vision
- Distorted central vision, for example, straight lines appear wavy
- Washed out or faded colors
- Vision loss in advanced stages
What are the causes for cystoid macular degeneration?
Macular edema is caused by leakage and accumulation of fluid in the macula when tiny blood vessels (capillaries) in the retina get damaged. The fluid collects in tiny sacs known as cysts, which obscure the central vision. Macular edema is not a disease by itself but is a symptom of an underlying condition.
Macular edema can occur from the following conditions:
- Diabetes: Diabetic retinopathy is a condition in which retinal blood vessels are damaged due to high blood sugar.
- Age-related macular degeneration (AMD): AMD is the degeneration of the macula that occurs with age. In wet AMD, abnormal blood vessels form and leak fluid into the macula.
- Eye surgery: Eye surgeries for cataracts or glaucoma can cause temporary damage to retinal blood vessels.
- Vascular diseases: Diseases such as high blood pressure or atherosclerosis can cause blood vessel blockages, leading to fluid leaks.
- Inflammatory diseases: Inflammatory diseases such as uveitis that affect the eye can damage the retinal tissue. The retina can also be affected by inflammatory immune system disorders such as:
- Cytomegalovirus infection
- Retinal necrosis
- Sarcoidosis
- Behcet’s syndrome
- Genetic eye disorders: Inherited genetic eye conditions such as:
- Retinitis pigmentosa, a condition in which retinal cells break down
- Retinoschisis, a condition in which retinal layers split abnormally
- Other conditions: Other conditions that can damage the macula include:
- Eye tumors
- Eye injury
- Certain medication side effects
What are the treatments for cystoid macular degeneration?
Treatment for macular edema depends on the condition that caused it. You may be required to undergo eye tests such as:
- Visual acuity test: Test with a chart of alphabets or numbers.
- Amsler grid: A simple test with a grid and a dot to focus on, one eye at a time, which can detect wavy central vision.
- Dilated eye exam: A physical exam in which the doctor uses eye drops and dilates the pupil to better examine the eye.
- Fluorescein angiogram: A test in which the doctor injects into the arm a dye that travels into the eye’s capillaries. The dye leaking through damaged blood vessels is captured in pictures with a special camera, which can show the extent and exact spot of leakage.
- Optical coherence tomography (OCT): Use of a device with a camera and light that enables the doctor to get a detailed view of the retina.
Treatment for macular edema includes treating the underlying condition. Common treatments for damage to the retina from macular edema include:
- Eye drops: Non-steroidal anti-inflammatory drug (NSAID) eye drops to control inflammation in cystoid macular edema which can occur after cataract surgery.
- Corticosteroids: Corticosteroids are the main treatment for macular edema from inflammatory diseases. Corticosteroids may be administered as oral pills or injections into the eye. Macular edema from chronic conditions is treated with retinal implants which slowly release the medication. FDA has approved the following corticosteroid implants:
- Dexamethasone (Ozurdex)
- Fluocinolone acetonide (Retisert, Iluvien)
- Anti-VEGF injections: Anti-VEGF is a medication that blocks the activity of a protein known as vascular endothelial growth factor (VEGF) that is essential for new blood vessel growth (angiogenesis). Anti-VEGF medications injected into the eye prevent abnormal blood vessel formation and leakage into the retina. Anti-VEGF drugs include:
- Bevacizumab (Avastin)
- Ranibizumab (Lucentis)
- Aflibercept (Eylea)
- Pegaptanib (Macugen)
- Laser treatment: Use of laser beam to seal leaking blood vessels in a process known as laser photocoagulation.
- Vitrectomy: Vitrectomy is a surgical procedure in which the doctor removes the vitreous, gel-like fluid that fills the space inside the eye between the lens and the retina. Vitrectomy is done when blood leaks into the vitreous clouding the vision, and the vitreous is replaced with clear fluid.
What are the risk factors for cystoid macular degeneration?
Cystoid macular degeneration is an autosomal dominant genetic form of macular degeneration. It starts in childhood or adolescence. Later, it affects the central vision. The best vitelliform macular dystrophy is related to an abnormality in the VMD2 gene. The early symptoms of cystoid macular degeneration are not noticeable. The other symptoms include blurry vision, faded colours, distorted central vision, and loss of vision. It can occur to-
1. Diabetic patients because retinal blood vessels are damaged due to high blood sugar
2. Age-related macular degeneration- this occurs with age due to degeneration of the macula
3. Eye surgery- retinal blood vessels are damaged due to eye surgeries
4. Vascular diseases- high blood pressure or atherosclerosis leads to blood vessel blockages.
5. Inflammatory diseases- This disease affects the eye retina. It can also be affected due to cytomegalovirus infection, retinal necrosis, sarcoidosis, and behcet's syndrome.
6. Genetic eye disorders- This includes retinitis pigmentosa, and retinoschisis.
7. Some other conditions that damage the macula include eye tumors, eye injury, etc.
8. A person who has cataract extractions will be at risk of a decrease in vision due to cystoid macular degeneration.
9. Other risk factors include disease that disrupts the blood-retinal barrier, such as diabetes mellitus, uveitis, retinal vein occlusion, retinal degeneration, macular degeneration, radiation retinopathy, and epiretinal membranes, choroidal tumors etc.
Symptoms
Blurry central vision,Wavy central vision,Colors that look washed out or different than usual,Difficulty reading,Double vision,Eye floaters (dark spots in your vision)
Conditions
A condition that happens when blood vessels in your retina leak fluid into a part of your eye called the macula. This can cause a buildup of fluid leading your macula to swell
Drugs
Anti-VEGF injections,Corticosteroids in the form of eye drops, pills, or injections
Is there a cure/medications for cystoid macular degeneration?
Cystoid macular degeneration is an autosomal dominant genetic form of macular degeneration. It starts in childhood or adolescence. Later, it affects the central vision. The best vitelliform macular dystrophy is related to an abnormality in the VMD2 gene. The early symptoms of cystoid macular degeneration are not noticeable. The other symptoms include blurry vision, faded colors, distorted central vision, and loss of vision. It can occur to-
Cure/medications for cystoid macular degeneration:
Certain eye tests are done depending on the condition, such as visual acuity test, Amsler grid, dilated eye exam, fluorescein angiogram, and optical coherence tomography.
Common medications include-
1. Eye drops- non-steroidal anti-inflammatory drug eye drops are used for cystoid macular edema
2. Corticosteroids- it is given as oral pills or injections into the eye. Some of the corticosteroids implants are Dexamethasone (ozurdex), Fluocinolone acetonide (retisert, iluvien)
3. Anti-VEGF (vascular endothelial growth factor) injections are given to avoid leakage into the eye. This may include bevacizumab (avastin), ranibizumab (lucentis), aflibercept (eylea), pegaptanib (macugen) etc.
Symptoms
Blurry central vision,Wavy central vision,Colors that look washed out or different than usual,Difficulty reading,Double vision,Eye floaters (dark spots in your vision)
Conditions
A condition that happens when blood vessels in your retina leak fluid into a part of your eye called the macula. This can cause a buildup of fluid leading your macula to swell
Drugs
Anti-VEGF injections,Corticosteroids in the form of eye drops, pills, or injections