Macular edema and macular degeneration are both common conditions that can affect vision. Without treatment, they can progress over time and may result in vision loss.

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This article explores the differences and similarities between macular edema and macular degeneration. In particular, we describe what they are, how they present themselves, and their effect on a person. We also discuss the diagnosis, treatments, and risk factors for both conditions.

Macular degeneration affects the macula, a part of the retina at the back of the eye. Doctors often refer to it as age-related macular degeneration (AMD). There are two types of macular degeneration: dry and wet forms.

Dry macular degeneration can cause blindness from atrophy, whereas the formation of atypical blood vessels results in wet macular degeneration. These blood vessels are susceptible to bleeding and fluid leakage, causing macular edema.

Below is an overview of each condition and how they differ.

Macular edema

Macular edema is the buildup of fluid in the macula, an area in the retina’s center. Fluid buildup causes the macula to swell and thicken.

This swelling can result from leaking fluids or blood and can cause blurry vision and vision loss.

Unlike macular degeneration, macular edema can develop for other reasons besides aging. According to this 2019 article, some of these include:

  • Diabetic macular edema: This affects people with complications from diabetes.
  • Eye surgery: Macular edema can also result from eye surgery, such as correcting cataracts, glaucoma, or retinal diseases. However, these are usually temporary and do not last long. Treatments involve eye drops that target inflammation.
  • Blockage: Individuals with blocked retinal vessels, which may relate to complications from high blood pressure or atherosclerosis, can leak into the retina.
  • Inflammatory diseases: A group of inflammatory diseases called uveitis destroys the eye tissues, resulting in swelling and breakdown of the macula. Some of these disorders include toxoplasmosis, sarcoidosis, and Eales disease.

Macular degeneration

Macular degeneration is the leading cause of vision loss and blindness for Americans ages 65 years and older.

Dry macular degeneration is the most common type, accounting for almost 80–85% of all cases. The wet type affects the remaining 15–20% and accounts for approximately 80% of severe vision loss.

According to this 2020 article, the below tests can help diagnose macular degeneration. These include:

  • Visual acuity test: An individual reads from rows of letters that decrease in size. The doctor can then determine how much the individual can see.
  • Dilated eye exam: The doctor places special drops in a person’s eyes. These drops dilate the pupils, allowing the ophthalmologist to detect any presence of blood vessel leakage or cysts that could indicate damage or disease.
  • Fluorescein angiogram: The doctor injects a type of dye into the arm that travels through the blood vessels. As it does so, a camera takes photos of the retina, allowing the specialist to see whatever damage there is in the macula.
  • Optical coherence tomography: The ophthalmologist uses a special light and camera that detect swelling in the macula.

Ophthalmologists treat wet macular degeneration with ocular injections. However, optometrists can also perform tests to diagnose these conditions.

Read more about tests for macular degeneration here.

A 2019 article explains that the Amsler grid is a way to check for changes in central vision. People use it for at-home monitoring after receiving a diagnosis of either macular edema or macular degeneration. This grid allows individuals to look at one eye at a time and check if they see any parts with distortion, missing pieces, or excessive darkness.

Learn more about using an Amsler grid.

However, a better way to know is to speak with an eye doctor or an ophthalmologist. They can carry out specific tests that can help diagnose macular edema and macular degeneration.

Treatments for both macular edema and macular degeneration can be similar. Some of the available treatments include:

  • Anti-vascular endothelial growth factor (anti-VEGF) injections: This is a painless procedure where a healthcare professional injects a drug into the fluid into a person’s eye to block the activity of blood vessel growth. These medications include Avastin, Eylea, and Lucentis.
  • Anti-inflammatory treatments: These include steroids and nonsteroids. The former include drugs and implants that release dosages of medication over a period of time. Nonsteroid options usually come in the form of drops.
  • Vitrectomy: In some cases of macular edema, the vitreous — the gel at the center of the eye — pulls on the macula, causing more damage. This outpatient surgery removes this gel and any blood that collects in the eye to correct vision.
  • Laser: A rare treatment that doctors may also use is focal laser photocoagulation. This procedure uses heat from a laser, which seals leaking blood vessels in the retina.

Doctors rarely use focal lasers for either condition since the introduction of anti-VEGF, as it has more side effects.

In 2021, the Food and Drug Administration (FDA) approved Byooviz as a treatment option for macular edema and macular degeneration.

According to a 2020 article, aging is the main risk factor for macular degeneration. As individuals age, the retinal cells can not keep up with the demand from the activity in the macula.

While there is little that people can do to prevent these side effects of aging, certain things can reduce some of the risks of getting the condition.

Macular degeneration risk factors

The main modifiable risk factor of macular degeneration is smoking.

Aside from genetic dispositions, other risk factors include:

The following conditions and factors could also lead to a higher probability of developing macular degeneration:

Macular edema risk factors

According to this 2019 article, these risk factors also coincide with those for macular edema. Others include:

Reducing risk factors

Suitable ways that may help in reducing the risk for both conditions include:

  • eating a nutritious diet
  • exercising
  • regular blood tests
  • regular checks ups to monitor for conditions such as:
  • regular eye checkups, including tests for conditions such as glaucoma
  • not smoking, if applicable, and avoiding secondhand smoke

Macular edema can be separate from macular degeneration, but wet macular degeneration could result in macular edema, where newer blood vessels leak fluid or blood.

Both can result from aging, though macular edema can also be due to other health conditions, blockages, or eye surgery.

One of the standard treatments for both is anti-VEGF injections. To reduce the risks of both eye problems, doctors recommend avoiding smoking if applicable, eating a nutritious diet, and regularly attending eyes tests to detect any early signs.