Maculopathy

Maculopathy is a collective term for diseases that affect the macula, the central portion of the retina responsible for high-acuity, detailed vision and color perception. The macula lies in the center of the retina and contains a high concentration of cone photoreceptors, enabling sharp central vision needed for tasks such as reading and recognizing faces.

The term covers a range of conditions, most notably age-related macular degeneration (AMD), diabetic macular edema (DME) or diabetic maculopathy, macular holes, and central serous chorioretinopathy. AMD is the leading cause of irreversible central vision loss in older adults and exists in dry (atrophic) and wet (neovascular) forms. DME results from diabetes-related damage to retinal vessels, causing swelling in the macula. Central serous chorioretinopathy involves the accumulation of fluid under the macula. Macular holes are full-thickness defects that can cause sudden central vision loss.

Symptoms commonly include blurred or distorted central vision, a central blind spot, metamorphopsia (lines appearing curved or bent), and sometimes reduced color perception. Diagnosis relies on ophthalmic examination and imaging such as optical coherence tomography (OCT) and fluorescein angiography.

Treatment depends on the specific condition. Wet AMD and DME are frequently treated with intravitreal injections of anti-VEGF agents. Dry AMD may be managed with dietary supplements containing antioxidants and zinc to slow progression in some cases. Macular holes are often repaired with surgical vitrectomy, while central serous chorioretinopathy may be observed or treated with laser therapy in persistent instances. Prognosis varies by disease, with some forms remaining stable and others causing ongoing central vision impairment. Risk factors include age, smoking, hypertension, and diabetes. Regular eye exams aid early detection and management.