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Macular diseases: AMD, macular oedema, central serous chorioretinopathy
These are conditions that affect central vision, and therefore reading and seeing fine detail. The most common include:
- Age-related macular degeneration (AMD)
This is a chronic disease of the macula that develops after the age of 50. Age, heredity and smoking are the main risk factors. Early on, small deposits form beneath the retina (drusen), usually without affecting vision; this is known as age-related maculopathy. It can progress to two advanced forms:
1) Atrophic AMD (or “dry” AMD): the cells of the macula gradually disappear. Progression is slow, over several years. There is currently no curative treatment in France. Quitting smoking, eating a diet rich in green vegetables and oily fish and, at certain stages, taking appropriate supplements can reduce the risk of worsening. Visual aids (magnifiers, lighting) make everyday life easier.
2) Neovascular AMD (or “wet” AMD): abnormal blood vessels develop beneath the macula and leak fluid or blood. Vision can deteriorate over a few days to a few weeks. The standard treatment is an intravitreal injection of an anti-VEGF medication, which slows the growth of these vessels. Injections are repeated over time, at intervals tailored to each patient based on OCT monitoring.
Straight lines that look wavy, a spot in the centre of your vision: seek medical attention promptly (within days!). An Amsler grid can be used to monitor each eye at home.
At the Paris 13 clinic, AMD diagnosis, OCT and OCT angiography monitoring, and intravitreal anti-VEGF injections are provided on site.
- Diabetic macular edema (DME)
This is a build-up of fluid in the macula caused by fragile retinal blood vessels in people with diabetes. It can occur at any stage of diabetic retinopathy and causes blurred, sometimes distorted, vision. OCT allows it to be measured accurately and monitored over time.
Management starts with controlling blood sugar and blood pressure (see your diabetologist!). When the edema affects the centre of the macula and reduces vision, first-line treatment consists of intravitreal anti-VEGF injections. An injectable steroid implant may be offered in some cases. Laser treatment is used in more specific cases. OCT monitoring and intravitreal injections for diabetic macular edema are provided at the clinic.
- Central serous chorioretinopathy (CSC)
It mainly affects men aged 30 to 50. Fluid leaks beneath the macula, lifting it like a small blister. This causes blurred or distorted vision, a darker spot or objects that appear smaller. Corticosteroids, in any form (tablets, injections, nasal or inhaled sprays, creams), and stress are the main contributing factors.
In most cases, the fluid is reabsorbed spontaneously within a few weeks to a few months, with good visual recovery. If you are taking corticosteroids, let us know: stopping them should be discussed with the doctor who prescribed them (never stop them abruptly on your own!). For cases that persist or recur, photodynamic therapy or laser treatment may be offered at a specialist centre.
