Macular edema simply means accumulation, or build-up, of fluid of the macula. Synonyms include; clinically significant macular edema (CSME), diabetic macular edema (DME), cystoid macular edema (CME) and retinal edema. There are slight nuances with some of the terms, but basically it means “swelling.”
Macular Edema – a generic term indicating fluid build up in the macula, but can be from any cause; diabetes, macular degeneration, vein occlusions; etc. I prefer to use it to distinguish macular swelling from macular degeneration versus diabetic retinopathy.
Diabetic Macular Edema (DME) – this is probably the most common term that I use and is found in the literature. This is basically the same as CSME, that is, swelling and thickening caused by diabetic retinopathy. I think it a more useful term as it contains the word “diabetic.” It becomes self explanatory.
Clinically Significant Macular Edema (CSME) – basically macular swelling related to diabetic retinopathy only. More specifically, it does imply that it meets certain criteria requiring treatment. It is a term that was created to establish when laser treatment was necessary to treat the macular edema due to diabetic retinopathy.
Cystoid Macular Edema (CME) – this is a bit more esoteric. It refers to macular fluid, or thickening, from really any cause, except diabetes. CME may develop after a retinal vein occlusion, following cataract surgery or cases of uveitis.
Retinal Edema is thickening of any part of the retina. It really means non-macular swelling. Since this has little or no impact on the vision (as the macula is uninvolved), it isn’t used very often. It is also too broad a term to have much use.
What Does This Mean? As I write, I try to keep the terms pretty straightforward. I think for our purposes diabetic macular edema (DME) is best suited for situations caused by diabetic retinopathy. Macular edema is a term best used for swelling from macular degeneration. Fewer terms; keeping it simple.
