Cystoid Macular Edema (CME): Symptoms, Causes, Tests, & Treatments

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What Is Cystoid Macular Edema (CME)?

It is a medical condition that affects the macula, the central part of the retina in the eye responsible for sharp central vision. It is characterized by the accumulation of fluid in the macula, leading to swelling and distortion of the central vision. It can result in blurred or distorted vision, making it difficult for individuals to see fine details or read small print.

CME – Goyal Eye

Symptoms of Cystoid Macular Edema (CME)

The most common symptoms of CME include:

  • Blurred Central Vision: Blurriness in the center of your vision is a hallmark symptom as it can make it difficult to see fine details and can affect tasks like reading or recognizing faces.
  • Distorted Vision: People may experience distortion in their central vision. Straight lines may appear wavy or bent, and objects may look distorted or stretched.
  • Reduced Visual Acuity: Visual acuity refers to the sharpness of your vision that can decrease, making it challenging to see things clearly, even when they are up close.
  • Color Vision Changes: Some people with CME report changes in their perception of colors. Colors may appear faded, washed out, or less vibrant.
  • Difficulty Reading: Reading can become challenging due to the central vision impairment. Words may appear blurry or distorted, making it hard to read text.
  • Central Scotoma: A scotoma is a blind spot in your visual field. The central vision is often affected, creating a central scotoma where you cannot see clearly.
  • Decreased Contrast Sensitivity: It refers to the ability to distinguish between objects of different shades or colors. CME can reduce contrast sensitivity, making it difficult to discern subtle shade differences.
  • Difficulty with Fine Detail Tasks: Tasks that require precise central vision, such as threading a needle or recognizing faces, can become problematic.
  • Glare Sensitivity: Some individuals with CME may experience increased sensitivity to glare from bright lights or sunlight.

Causes of Cystoid Macular Edema (CME)

  • Inflammatory Eye Conditions: Inflammation, also known as uveitis, can cause CME due to infections, autoimmune diseases, or other inflammatory disorders.
  • Diabetic Retinopathy: People with diabetes are at risk of developing Diabetic Macular Edema (DME), a type of CME.
  • Postoperative Complications: A complication following certain eye surgeries, particularly cataract surgery.
  • Age-Related Macular Degeneration (AMD): AMD, particularly the wet form of the disease, can result in CME as a complication.
  • Retinal Vein Occlusion: A blood clot or other blockage occurs in the retinal veins, categorized as Branch Retinal Vein Occlusion (BRVO) or Central Retinal Vein Occlusion (CRVO).
  • Vitreomacular Traction: In some cases, the vitreous gel in the eye can exert traction on the macula caused by vitreomacular traction syndrome.
  • Medications: Certain medications, such as prostaglandin analogs used to treat glaucoma, can trigger CME as a side effect in some individuals.
  • Radiation Therapy: Radiation treatment for eye tumors or other conditions.
  • Systemic Diseases: Systemic conditions like hypertension (high blood pressure) and vascular diseases can contribute to such situations by affecting blood vessel integrity in the eye.
  • Infections: Eye infections or inflammatory diseases involving the eye can lead to CME in some cases.

What Experts Say?

Anshul Goyal

Dr. Anshul Goyal

Retina Surgeon (CEO)

“Today there are excellent medicines available to successfully treat CME. A good retina specialist can decide the best injection for you based on the underlying cause of the CME.”

Diagnostic Tests for Cystoid Macular Edema (CME)

Here are some common diagnostic tests used to determine the causes of CME:

  • Visual Acuity Testing: Using an eye chart, this simple test assesses how well you can see at various distances.
  • Dilated Eye Examination: During a dilated eye exam, the ophthalmologist or optometrist uses eye drops to dilate your pupils, allowing a detailed examination of the retina and macula.
  • Optical Coherence Tomography (OCT): OCT is a non-invasive imaging technique that provides high-resolution cross-sectional images of the retina.
  • Fluorescein Angiography: A fluorescent dye is injected into a vein in your arm, and a series of photographs are taken as the dye flows through the blood vessels in the eye.
  • Indocyanine Green Angiography: This dye-based imaging technique is similar to fluorescein angiography but provides additional information about the choroidal blood vessels beneath the retina.
  • Ultrasound: In some cases, an ultrasound of the eye (B-scan or A-scan) may be performed to evaluate the retina and surrounding structures.
  • Blood Tests: If a systemic disease or infection is suspected as the underlying cause of CME, blood tests may be conducted to assess conditions such as diabetes, autoimmune diseases, or hypertension.
  • Medical History and Review of Medications: Providing a detailed medical history and information about any medications you are taking can help identify potential causes or triggers.
  • Electroretinography (ERG): An electrical test that measures the function of the retina's light-sensitive cells (rods and cones).
  • Genetic Testing: In some cases, genetic testing may be recommended, particularly if a hereditary component is suspected of developing retinal conditions.

Treatment for Cystoid Macular Edema (CME)

  • Anti-Inflammatory Medications: Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) and corticosteroids may be prescribed to reduce inflammation in the eye and alleviate macular edema.
  • Intravitreal Injections: Intravitreal injections of anti-vascular endothelial growth factor (anti-VEGF) drugs, such as ranibizumab (Lucentis), aflibercept (Eylea), or bevacizumab (Avastin), are used.
  • Laser Therapy: Laser photocoagulation or focal/grid laser treatment may seal leaking blood vessels or reduce fluid accumulation in the macula.
  • Corticosteroid Implants: In some cases, long-acting corticosteroid implants, such as dexamethasone (Ozurdex) or fluocinolone (Iluvien), may be surgically implanted in the eye to provide sustained anti-inflammatory effects.
  • Vitrectomy: The vitreous gel inside the eye and any traction or scar tissue are removed during this surgical procedure.
  • Therapeutic Contact Lenses: In some cases, specially designed contact lenses may improve vision and reduce symptoms.
  • Low Vision Rehabilitation: It helps individuals maximize their remaining vision and adapt to their visual impairment.

Frequently Asked Questions (FAQs) About Cystoid Macular Edema (CME)

Yes, treatment options are available that may include medications like corticosteroids or anti-VEGF drugs, laser therapy, or surgical interventions, depending on the underlying cause.
CME can be either temporary or chronic, depending on its cause and how it responds to treatment. Some cases may be resolved with treatment, while others require ongoing management.
Preventive measures can include managing underlying conditions like diabetes or hypertension, avoiding medications known to increase the risk of this condition, and regular eye check-ups for early detection.
Severe and untreated cases can lead to vision loss, but it typically doesn't result in complete blindness. Timely diagnosis and appropriate treatment can help prevent significant vision impairment.
It is relatively uncommon but can occur in individuals with certain risk factors or underlying health conditions.

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