Bilateral fingolimod-associated macular oedema development after cataract surgery

2021 ◽  
Vol 14 (6) ◽  
pp. e240562
Author(s):  
Matthew Gillam ◽  
Theresa Richardson
Keyword(s):  
Multiple Sclerosis ◽  
Cataract Surgery ◽  
Macular Oedema ◽  
Topical Therapy ◽  
Cystoid Macular Oedema ◽  
Topical Steroids ◽  
Visual Recovery ◽  
Anti Inflammatory

Postoperative cystoid macular oedema (CMO) is a recognised complication of cataract surgery, occurring in around 1.5% of cases. It is generally managed with topical steroids or non-steroidal anti-inflammatory medications. We present a case of a patient who developed bilateral sequential CMO following bilateral sequential cataract surgery which was non-responsive to topical therapy and worsened following sub-Tenons administration of steroid. The patient took fingolimod for multiple sclerosis both prior to and during the period of cataract surgery which is known to result in the development of macular oedema in some patients. On fingolimod cessation, the oedema resolved over a period of 5 months with good visual recovery. We present this case to inform cataract surgeons of the risk of fingolimod-associated macular oedema in patients undergoing cataract surgery and to inform neurologists of the potential need to adjust treatment for patients undergoing cataract surgery.

scholarly journals Topical bromfenac versus prednisolone: post cataract surgery safety and efficacy

2020 ◽  
Vol 7 (4) ◽  
pp. 1375
Author(s):  
Harish R. Trivedi ◽  
Harsha Maheshwari
Keyword(s):  
Intraocular Pressure ◽  
Cataract Surgery ◽  
Macular Oedema ◽  
Cystoid Macular Oedema ◽  
Posterior Chamber ◽  
Prednisolone Acetate ◽  
Eye Drops ◽  
Small Incision Cataract Surgery ◽  
Postoperative Inflammation ◽  
Anti Inflammatory

Background: Cataract surgery can result in postoperative inflammation which increases the risk of complications like increased intraocular pressure (IOP), uveitis and cystoid macular oedema. We aim to evaluate the effectiveness of topical non-steroidal anti-inflammatory drug bromfenac and topical prednisolone in controlling intraocular inflammation after uncomplicated cataract surgery and compare intraocular pressure (IOP) differences, degrees of anterior chamber inflammation and macular oedema between two different treatments.Methods: 100 patients undergoing manual small incision cataract surgery with PMMA posterior chamber intraocular lens implantation were randomly assigned to receive either Bromfenac (0.09%) eye drops or prednisolone acetate (1%) eye suspension as their postoperative anti-inflammatory medication with 50 cases in each group. The patients were examined at the day 1, day 7, day 15, and day 30 after surgery. Postoperative inflammation was evaluated subjectively by intraocular pressure, slit-lamp assessment of signs of inflammation in the form of aqueous cells and flare and optical coherence tomography to rule out post-operative macular oedema.Results: Both the drugs are equally effective in controlling post-operative inflammation and post-operative cystoid macular oedema.Conclusions: Bromfenac (0.09%) is an effective drug in controlling ocular inflammation after un-complicated cataract surgery having effect similar to topical Prednisolone acetate (1%) with minimal side effects and less frequent dosing.

scholarly journals Efficacy of additional topical betamethasone in persistent cystoid macular oedema after carbonic anhydrase inhibitor treatments in retinitis pigmentosa

2018 ◽  
Vol 3 (1) ◽  
pp. e000107
Author(s):  
Shohei Kitahata ◽  
Yasuhiko Hirami ◽  
Seiji Takagi ◽  
Cody Kime ◽  
Masashi Fujihara ◽  
...  
Keyword(s):  
Carbonic Anhydrase ◽  
Retinitis Pigmentosa ◽  
Macular Oedema ◽  
Medical Records ◽  
Cystoid Macular Oedema ◽  
Topical Steroids ◽  
Foveal Thickness ◽  
Central Foveal Thickness ◽  
Corrected Visual Acuity ◽  
Iop Elevation

ObjectiveWe investigated the efficacy of additional topical betamethasone in persistent cystoid macular oedema (CMO) after carbonic anhydrase inhibitors (CAIs) therapy.Methods and analysisThis retrospective cohort study included 16 eyes of 10 patients with retinitis pigmentosa (RP). All patients were previously administered CAI for at least 3 months to treat CMO secondary to RP and lacking an effective reduction (≥11%) of central foveal thickness (CFT). We administered topical 0.1% betamethasone daily in each affected eye following a preceding course of the CAI medication as a first treatment. CMO was diagnosed using spectral-domain optical coherence tomography. CFT was regarded as the average of vertical and horizontal foveal thickness. Best-corrected visual acuity (BCVA) and intraocular pressure (IOP) were obtained from patient medical records. We compared the CFT and BCVA between baseline and the average of 1–3, 5–7, 10–14 and 16–20 months period.ResultsIn treatments with brinzolamide in 14 eyes, dorzolamide in 2 eyes and bromfenac in 2 eyes, CFT effectively decreased in 12 of 16 eyes (81%). CFT decreased significantly in 1–3 months (326±102 µm; n=16; P=0.029) and 5–7 months (297±102 µm; n=12; P=0.022) compared with baseline but not within 10–14 months (271±96 µm; n=9; P=0.485) or 16–20 months (281±134 µm; n=9; P=0.289). There were no significant intergroup differences in BCVA throughout the study. Betamethasone treatment was stopped in three patients because of IOP elevation.ConclusionOur data suggested that additional betamethasone might improve treatments for persistent CMO. Topical steroids could be an alternative option for managing persistent CMO in RP.

Topical non-steroidal anti-inflammatory agents for diabetic cystoid macular oedema

2015 ◽  
Author(s):  
Soumendra Sahoo ◽  
Ankur Barua ◽  
Kay Thi Myint ◽  
Adnaan Haq ◽  
Adinegara BL Abas ◽  
...  
Keyword(s):  
Macular Oedema ◽  
Cystoid Macular Oedema ◽  
Anti Inflammatory
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