2. Macular abnormalities

Macular edema

•Result of increased fluid and protein deposits within the neuroretina in the macula.

•Swelling may distort the central vision, as the macula is near the center of retina.

•May be differentiated into cystoid and non-cystoid.

Figure 2.1 LeftHard exudate formation around the macula (Non-cystoid) RightThickening of fovea associated with microcyst (Cystoid)

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•Causes of macular edema:

i.Retinal vascular disease (Background diabetic retinopathy, retinal vein occlusion)

ii.neovascular

iii.retinitis pigmentosa

iv.iatrogenic (eye surgery, eg: retinal detachment surgery, retinal cryotherapy)

Stellate Maculopathy (Figure 2.3)

•Retinal hard exudates forming a macular star

•Frequently associated with optic disc swelling

Figure 2.2 Macular Star

Diabetic Maculopathy

1.Poor near vision, not corrected by Plus lenses

2.Usually assymetrical

3.The commonest cause for poor vision in diabetes patients is macular edema especially in NIDDM.

*Central Serous Retinopathy (Of interest) – Figure 2.4

•Localized detachment of sensory retina at the macula secondary to focal RPE defects.

•Self-limiting, usually affecting young/middle-aged men with Type A personality.

•Sub-retinal fluid around macula (elevation as indicated by the “climb” by vessels on macula.

Figure 2.4 CSR

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