[Macular edema: from symptom to diagnosis].
BACKGROUND
In this study, the "Macular edema" syndrome is examined in detail from the symptoms right through to the diagnosis. The 9 most important differential diagnoses are also listed, as well as a summary of the currently applicable therapy recommendations.


METHODS
This overview is based on existing literature as well as own case studies.


RESULTS
The symptoms of macular edema consist of visual acuity deterioration, micropsy, metamorphopsy, reduced colour perception, as well as central or paracentral scotoma. Ophthalmologist checks should include a case history (age, diabetes, hypertonia, allergies, cataract surgery?), a detailed examination of the fundus, if possible with a slit-lamp and a contact or non-contact lens, whereby one must pay attention here to the swelling of the retina as well as the presence of hard exsudates in the macular region. It is important to use fluorescence angiography in this case, to achieve a correct differential diagnosis, and eventually for treatment. This angiography may equally reveal a capillary leakage, a cystoid macular edema, a leaking point or a choroidal neovascularization. The differential diagnosis can be divided into the following commonly-occurring groups: age-related macular degeneration/macular edema after a branch or central retinal vein thrombosis/central serous chorioretinopathy/Irvine-Gass syndrome after cataract operation/uveitis/epiretinal fibroplasia/juxtafoveal retinal teleangiectasis and tumors (choroidal melanoma, metastasis and hemangioma).


METHODS
Apart from the seldomly applicable causal therapy, the following treatments can be used: laser photocoagulation, anti-inflammatory and rinse medication, and in some cases vitrectomy as well as a low dosage of radiation therapy.


CONCLUSIONS
In the case of macular edema the ophthalmologist's responsibility is to perform a differential diagnosis and recommend appropriate and sensible methods or treatment.
Klinik für Augenkrankheiten, Kantonsspital St. Gallen. aca@ms1.kssg.ch
P
P
Bischoff
D003937:Diagnosis, Differential; D005451:Fluorescein Angiography; D006801:Humans; D008269:Macular Edema / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D013577:Syndrome
Makulaödem: Vom Symptom zur Diagnose.