Macular-Related Issues: Symptoms and Connections to Eye Health

Macular-related issues?

Hello Doctor: My left and right eye prescriptions are both around 800, and I am regularly using eye pressure medication and undergoing check-ups.
My issue is that when I open my eyes or shift from a dark area to a bright background, I see small black spots.
However, they are not floaters because they do not move; the "spot" lasts for about 3 seconds before gradually fading.
If the "spot" happens to align with a grid line, it lasts even longer before disappearing, and it causes the lines to appear interrupted or distorted.
The OCT did not show any problems, but the electroretinogram indicated some differences in my left eye.
Finally, after undergoing fluorescein angiography, it was found that there is microvascular inflammation in my eyes.
I can't remember if there was any bleeding.
The doctor mentioned that this is related to my ankylosing spondylitis...
1.
If there is no inflammation, can I fully recover without any sequelae? 2.
Is this related to my macula and retina, and does it count as a type of degeneration or pathology? Thank you for your patience in reading this.

Xiao Lin, 20~29 year old female. Ask Date: 2017/07/26

Dr. He Jianxian reply Ophthalmology

1.
If the inflammation is indeed the cause, even after the inflammation subsides, complete recovery may not be guaranteed, as there is a possibility of permanent damage occurring during the process.
2.
I am not aware of the location of your inflammation; if it is peripheral, it should not be related to the macula, and this is likely a vascular condition affecting the retina.

Reply Date: 2017/07/26

More Info

Hello,
Thank you for sharing your concerns regarding your eye health. Based on your description, it seems that you are experiencing symptoms that could be related to a few different ocular conditions, particularly those associated with the macula and the retina. Let's break down your questions and provide some insights.

1. Recovery from Inflammation: If the inflammation of the microvasculature in your eye is effectively treated and there are no complications, it is possible to achieve a full recovery without lasting effects. However, the extent of recovery can depend on several factors, including the severity of the inflammation, how quickly treatment was initiated, and your overall health. Regular follow-ups with your ophthalmologist are crucial to monitor your condition and ensure that any potential complications are addressed promptly.

2. Connection to Macular and Retinal Health: The symptoms you describe, such as seeing small black dots that do not float and cause distortion in your vision, can indeed be related to issues with the macula or retina. The macula is responsible for central vision and is particularly sensitive to changes in blood flow and inflammation. The fact that your electroretinogram (ERG) shows differences in your left eye suggests that there may be some underlying retinal dysfunction, which could be linked to your history of spondyloarthritis. Chronic inflammatory conditions can have systemic effects, including on the eyes, leading to conditions such as uveitis or retinal vascular issues.

The presence of microvascular inflammation can indicate that there is some level of vascular compromise, which might affect the retina and macula. While OCT (Optical Coherence Tomography) is a powerful tool for assessing retinal structure, it may not always capture subtle changes in retinal function or microvascular health. Therefore, your symptoms warrant careful monitoring and possibly further investigation, such as additional imaging or functional tests.

3. Is it a Degenerative Condition?: The symptoms you are experiencing do not necessarily indicate a degenerative condition like age-related macular degeneration (AMD) or other forms of retinal degeneration. However, they do suggest that there may be some form of retinal pathology that needs to be understood better. The inflammation of the microvasculature could be a response to your underlying systemic condition, and while it may not be classified as a degenerative disease, it is essential to manage it effectively to prevent potential complications.

In summary, your symptoms are significant and should be closely monitored by your eye care provider. It is essential to maintain regular check-ups, adhere to prescribed treatments, and report any changes in your vision immediately. If you have concerns about the long-term implications of your eye health, discussing these with your ophthalmologist can provide clarity and help you understand the best course of action moving forward.

Take care of your eye health, and don't hesitate to reach out to your healthcare provider with any further questions or concerns.

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