Mechanisms of macular edema: Beyond the surface

Publication date: March 2018Source: Progress in Retinal and Eye Research, Volume 63Author(s): Alejandra Daruich, Alexandre Matet, Alexandre Moulin, Laura Kowalczuk, Michaël Nicolas, Alexandre Sellam, Pierre-Raphaël Rothschild, Samy Omri, Emmanuelle Gélizé, Laurent Jonet, Kimberley Delaunay, Yvonne De Kozak, Marianne Berdugo, Min Zhao, Patricia Crisanti, Francine Behar-CohenAbstractMacular edema consists of intra- or subretinal fluid accumulation in the macular region. It occurs during the course of numerous retinal disorders and can cause severe impairment of central vision. Major causes of macular edema include diabetes, branch and central retinal vein occlusion, choroidal neovascularization, posterior uveitis, postoperative inflammation and central serous chorioretinopathy. The healthy retina is maintained in a relatively dehydrated, transparent state compatible with optimal light transmission by multiple active and passive systems. Fluid accumulation results from an imbalance between processes governing fluid entry and exit, and is driven by Starling equation when inner or outer blood-retinal barriers are disrupted. The multiple and intricate mechanisms involved in retinal hydro-ionic homeostasis, their molecular and cellular basis, and how their deregulation lead to retinal edema, are addressed in this review. Analyzing the distribution of junction proteins and water channels in the human macula, several hypotheses are raised to explain why edema forms specifically in...
Source: Progress in Retinal and Eye Research - Category: Opthalmology Source Type: research