Cystoid Macular Edema

What is cystoid macular edema?

Cystoid macular edema is a type of swelling (edema) that happens in your macula. Your macula is the central part of your retina. It plays an important role in your sight because it’s responsible for your central vision. It helps you see color and fine details, like individual bricks on buildings or leaves on trees. Sometimes when your macula swells with fluid, it does so in cyst-like patterns (cystoid).

What are the symptoms of cystoid macular edema?

If you have cystoid macular edema, you might not notice any symptoms. Or you might notice changes in your vision, like:

• Blurred vision or distorted vision, typically in the middle of your field of view.
• Colors that appear different than usual, like things that look pink even when they’re not.
• Objects that seem dim, dark or misshapen.

What causes cystoid macular edema?

There are many known causes of cystoid macular edema. These include:

• Inflammation after eye surgery, including cataract surgery and repair of a detached retina.
• Diabetes.
• Blockage in veins of your retina (retinal vein occlusion).
• Inflammation of your eye.
• Injury to your eye.
• Side effects of medications.

What are the risk factors for cystoid macular edema?

Cystoid macular edema often develops after surgery for cataracts. You may be more at risk of developing cystoid macular edema after surgery if you have certain medical conditions like:

• Retinal vein occlusion (RVO).
• Uveitis.
• Epiretinal membrane (macular pucker).
• Macular hole.
• Diabetes.
• Retinitis pigmentosa.

Some medications, including vitamin B3 (niacin) and diabetes medications can increase your risk for cystoid macular edema. Also, if you have cystoid macular edema in one eye, you might get it in your other eye.

What are the complications of cystoid macular edema?

Untreated cystoid macular edema could lead to vision loss and low vision.

How is cystoid macular edema diagnosed?

Your provider may use one or more of these tests to diagnose cystoid macular edema: 

• Dilated retinal exam: Your provider may be able to use a special lens to see your macula and identify the cyst-like swelling.
• Fluorescein angiography: This method uses a special camera system to identify leaking blood vessels and the cystoid macular edema that might come with it.
• Optical coherence tomography (OCT): OCT has become one of the best ways to diagnose and identify cystoid macular edema. This noninvasive test uses a special light to create a high-resolution cross-sectional image of tissues, including your retina.

How is cystoid macular edema treated?

Treatment depends on what’s causing your cystoid macular edema. Only an eye care provider can recommend the right treatment. You may need to see a retina specialist, an ophthalmologist trained in retinal diseases. With treatment, your vision will likely improve.

Cystoid macular edema treatments

Treatments for cystoid macular edema include:

• Steroidal or nonsteroidal anti-inflammatory eye drops.
• Injections of medications into the gel-like substance that fills your eye (the vitreous). These medications stop new blood vessels from forming and leaking.
• Drugs that treat eye pressure may help the swelling to decrease.
• Laser treatment to stop blood vessels from leaking (photocoagulation).
• Surgery to remove the gel that fills your eye (vitrectomy).

Complications/side effects of treatments for cystoid macular edema

The chance is low for complications or side effects related to treating cystoid macular edema but risks always exist. For instance:

• There’s a risk of bleeding or infection with injections.
• Injections can also cause eye redness and irritation. This may be from the injections themselves or the cleaning solution used to reduce the chance of an infection before the injection.

How soon after treatment will I be able to get back to work or school?

Usually there are no restrictions after treatment. You don’t have to wait to go back to work or school unless you have a vitrectomy.

Recovering from a vitrectomy will take longer than other therapies. You may need to be off work for one to three weeks.

How can I reduce my risk of developing cystoid macular edema?

You may be able to reduce your risk of developing cystoid macular edema by:

• Managing chronic conditions like diabetes and high blood pressure (hypertension).
• Getting regular eye exams.
• Quitting smoking.
• Eating a nutritious diet.
• Getting regular physical activity.
• Using protective eyewear when working or participating in sports to help prevent eye injury and the infections that can follow them.

What can I expect if I have cystoid macular edema?

If you have cystoid macular edema and get treatment, you’ll likely stabilize your vision and reverse damage. You’ll need to have regular appointments with your eye care provider.

Without treatment, cystoid macular edema can cause worsening vision loss.

When should I see my healthcare provider?

It’s important to follow the suggestions of your eye care provider if you have a medical condition that can affect your eyesight, including cystoid macular edema. Regular appointments will help you and your provider identify any issues that may develop quickly.

Always contact your provider about any changes in your vision, such as blurred vision or distorted vision.

If you have any sudden loss of vision or a wound that punctures your eye, go to the emergency room. You need immediate medical care.

What questions should I ask my provider?

You may want to ask your provider questions about cystoid macular edema, such as:

• What do I need to know about cystoid macular edema?
• What treatment do you recommend?
• What are the side effects of this treatment?
• What can I expect in the future?
• Are there warning symptoms I should watch out for?
• What type of appointment schedule should I follow?
• Do you recommend any lifestyle changes?
• Do you recommend testing my family members for cystoid macular edema?

A note from Cleveland Clinic

Eye diseases can be frightening. It’s important to get regular eye exams and to contact an eye care provider when your vision changes. Early detection and early treatment lead to the best results.