If your ophthalmologist makes a macular edema diagnosis due to diabetes or retinal vein occlusion, focal laser treatment is often used to reduce swelling of the macula. With this form of laser surgery, your ophthalmologist applies many tiny laser pulses to areas of fluid leakage around the macula. The main goal of treatment is to stabilize vision by sealing off leaking blood vessels that interfere with the proper function of the macula. In some cases, vision loss may be improved with laser treatment.
A patient may need focal laser surgery more than once to control the leaking fluid. If you have macular edema in both eyes and require laser surgery, generally only one eye will be treated at a time, usually several weeks apart.
Medication injection therapy is also being used to treat macular edema. Two drugs —steroids and anti-VEGF agents — have shown promise in reducing diabetic macular edema.
Anti-VEGF drugs target a specific chemical in your eye called vascular endothelial growth factor — or VEGF — that is critical in causing abnormal blood vessels to grow under the retina. Several drugs have been developed that can block the trouble-causing VEGF. An anti-VEGF drug can help treat macular edema by reducing the growth of abnormal blood vessels and slowing their leakage, which helps to slow vision loss.
Medication injection therapy is performed in the doctor's office. An anesthetic is used to numb the eye, and a tiny needle is inserted into the eye to deliver the medication near the retina.
For people with diabetes, controlling blood sugar and blood pressure is another method of macular edema treatment.
To treat cystoid macular edema, where the eye is irritated by the presence of a new lens, your ophthalmologist may prescribe non-steroidal anti-inflammatory (NSAID) eyedrops for a few months. If these drops do not help to reduce the edema and improve vision, you may need to use steroid drops. Sometimes, more powerful steroid injections around or even inside the eye may be used. In rare cases, when cystoid macular edema does not respond to drops or shots, vitrectomy surgery may be needed to clear the gel inside the eye. Also, in rare instances, a lens replacement may be required.
Sometimes the swelling in your eye can cause you to have increased pressure within the eye, called glaucoma. In such cases, your ophthalmologist will treat you with medicines to control your glaucoma.
Depending on the cause of the macular edema and the treatment plan your doctor has recommended, the macular edema may take several months to resolve. During this time, it is important to follow the treatment regimen that your ophthalmologist recommends in order for your treatment to be effective.