General Pathophysiology

Macular edema represents a common final pathway of many intraocular and systemic diseases, which usually involve the retinal vessels. It typically occurs with painless impairment of visual acuity in one eye, but can also be bilateral, depending on the etiology. A macular edema is a nonspecific sign of many ocular disorders. Usually the symptoms progress slowly. Nevertheless, patients often may notice this entity suddenly – this is the case when they examine one eye separately. The appearance can differ with several subtypes existing, depending on the etiology. In this presentation the following mechanisms and problems of this non‐specific disease entity will be discussed: Unique construction of the blood‐retinal‐barrier und general possibilities of alteration. Inflammatory mediators with major focus on Angiotensin II, VEGF and Prostaglandins. Other cytokines and Chemokines as well as Matrix metalloproteinases. Sorbitol pathway and oxidation (Diabetes) – relation to inflammation. Mechanical issues (venous diseases). In addition it will be mentioned how this knowledge on pathophysiology translates into clinical praxis when we design treatment strategies for our patients.