maculopathie

Maculopathy is a group of disorders that affect the macula, the central part of the retina responsible for detailed, straight-ahead vision. Damage to the macula can cause blurred or distorted central vision and, in some cases, a central blind spot while peripheral vision remains intact. The term encompasses several conditions, most notably age-related macular degeneration (AMD), diabetic macular edema, macular edema from retinal vein occlusion, myopic maculopathy, and various inherited macular dystrophies, as well as macular holes and central serous chorioretinopathy.

Causes and forms vary. The most common forms are dry (atrophic) AMD and wet (neovascular) AMD, followed by macular edema due to diabetes or retinal vein occlusion. Myopic maculopathy occurs with high myopia, and inherited dystrophies such as Stargardt disease affect younger individuals. Other maculopathies include central serous chorioretinopathy and macular holes. Risk factors include age, smoking, hypertension, high cholesterol, and poor diabetes control.

Symptoms typically involve changes in central vision: blurred or distorted lines, a central dark or empty area, difficulty reading or recognizing faces, and altered color perception. Peripheral vision is usually preserved.

Diagnosis relies on a comprehensive eye exam and imaging. Optical coherence tomography (OCT) provides cross‑sectional macular images; fluorescein or indocyanine green angiography assesses retinal circulation; fundus photography and visual acuity testing are used to monitor progression and guide treatment.

Treatment depends on the specific condition. Wet AMD and other neovascular maculopathies are commonly treated with intravitreal anti‑VEGF injections to reduce fluid and abnormal vessel growth; laser or photodynamic therapy may be used in some cases. Dry AMD has no cure, but progression can sometimes be slowed with lifestyle measures and antioxidant supplements in selected patients. Other maculopathies may involve steroids, laser therapy, surgery for macular holes, or vision rehabilitation and supportive care.