The central portion of the retina is known as the macula. The macula contains the highest concentration of cone photoreceptor cells, which are responsible for our ability to perceive fine details and see color in high resolution. At the center of the macula is a small indent known as the fovea.
Symptoms of Macular Conditions
When something is wrong with the macula, it causes a wide range of visual disruptions and symptoms. Because of the macula’s size and highly specialized function, most of these conditions exhibit the same symptoms. The most common signs of macular conditions include:
- Blurry vision
- Visual distortions (straight lines appearing curvy, crooked, or wavy)
- Eye floaters
- Colors appearing dull
- Darkened areas in central vision
- Difficulty reading, watching TV, or seeing fine details of objects
Macular edema, which is swelling of the macula caused by excessive fluid buildup, is commonly found alongside many other eye conditions, such as:
- Diabetic retinopathy
- Macular degeneration
- Eye inflammation
- Retinal vein occlusion
- Eye injuries
- Hereditary illnesses
When macular edema is caused by diabetic retinopathy, it is known as diabetic macular edema (DME). This occurs when high levels of blood glucose damage the retinal blood vessels, causing them to leak into the macular region and cause swelling. DME can eventually lead to permanent vision loss.
Vitreomacular Traction Syndrome (VMT)
Vitreomacular traction syndrome (VMT) is a retinal disorder that is commonly associated with posterior vitreous detachment (PVD). PVD is a normal process of aging in which the vitreous gel contained within the posterior segment of the eye diminishes in both quantity and thickness. Most of the time, this happens without causing any issues. However, if the vitreous gel is partially connected to the retinal tissue, it can create a tractional force that tugs at the retina. This can lead to structural damage of the retina, retinal tear or detachment, and other macular complications, including macular holes and macular puckers.
When a small break or tear occurs in the macula, it is known as a macular hole. Macular holes are often caused by the tractional force created in PVD. Macular holes are a progressive condition that generally starts with the fovea losing its contour. As the contour flattens, small defects appear in the macula. At this point, these defects can sometimes heal on their own but often progress to the next phase of damage if left untreated.
Eventually, once the macular hole appears, it begins to increase in thickness. As this occurs, visual acuity declines at a noticeable rate. In their most severe form, macular holes can result in the vitreous gel separating from the optic disc, leading to serious vision loss.
Macular Pucker / Epiretinal Membrane
Macular puckers, also referred to as epiretinal membranes, are a type of scar tissue that forms over the macula, appearing as bulges or wrinkles in the macular tissue. Similar to macular holes, macular puckers are often caused by PVD. Other common causes of macular puckers include injuries, retinal detachment, as a side-effect of cataract surgery, and eye inflammation.
How Macular Conditions Are Treated
Macular conditions can be treated using a wide range of techniques, including:
- Monitoring the condition’s progression and managing underlying conditions
- Laser photocoagulation, which is used to seal off leaky blood vessels
- Vitrectomy surgery, in which the vitreous gel is removed from the eye so that the macula is more accessible for repair
- Anti-VEGF eye injections, which inhibit the growth of new abnormal blood vessels