The treatment method of persistent macula edema after phaco-vitrectomy

2021 ◽  
pp. 57-61
Author(s):  
E.M. Molokotin ◽  
◽  
Y.I. Malakhova ◽  
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Intravitreal Injection ◽  
Cystoid Macular Edema ◽  
Treatment Method ◽  
Chronic Uveitis ◽  
Macula Edema ◽  
Results Of Treatment ◽  
Subtenon Injection ◽  
Anti Inflammation

Purpose. To show the result of treatment of persistent macular edema as complication of chronic uveitis after phaco-vitrectomy. Material and methods. At this clinical case we show the results of treatment one patient, who was treated at the ophthalmological clinic «EYE Doctor», Almaty, Kazakhstan. He had complication of chronic uveitis as persistent macular edema after phaco-vitrectomy. The complex treatment (instillation of non-steroid anti-inflammation drops and subtenon injection of diprospan) was unsuccessful. Results. The result of treatment is successful; we get stable decrease of severity of cystoid macular edema and stabilization of visual acuity. Conclusion: This method allows to decrease the cystoid macular edema and to stable the visual acuity. It helps us to treat the patients, when other methods are unsuccessful and there is no financial possibility for treatment with intravitreal injection «Ozurdex». Key words: persistent macular edema, chronic uveitis, Diprospan, intravitreal injection.

scholarly journals Intravitreal and Subtenon Depot Triamcinolone as Treatment of Retinitis Pigmentosa Associated Cystoid Macular Edema

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Sidnei Barge ◽  
Renata Rothwell ◽  
Paula Sepúlveda ◽  
Luís Agrelos
Keyword(s):  
Visual Acuity ◽  
Retinitis Pigmentosa ◽  
Macular Edema ◽  
Intravitreal Injection ◽  
Cystoid Macular Edema ◽  
Treatment Options ◽  
Corrected Visual Acuity ◽  
Anatomic Results ◽  
The Right ◽  
Decrease In Visual Acuity

We present a case of retinitis pigmentosa (RP) related cystoid macular edema (CME) refractory to oral acetazolamide and topical ketorolac that was treated with intravitreal and subtenon depot triamcinolone. A 32-year-old male with RP presented with complaints of bilateral decrease in visual acuity. His best-corrected visual acuity (BCVA) was 20/50 in the right eye and 20/100 in the left eye. After being informed of the available treatment options, the patient received bilateral intravitreal injection triamcinolone. The patient’s BCVA improved to 20/40 in the right eye and 20/50 in the left eye and the CME was resorbed. However, 5 months after the injection in the left eye and two months in the right eye, visual acuity decreased due to recurrence of CME. We performed a second intravitreal injection in the left eye with improvement of visual and anatomic results, but we observed a recurrence of CME. Afterwards, we treated the patient with subtenon depot triamcinolone in both eyes, with the result that there was no recurrence after 4 months in OD or after 3 months in OS. We conclude that intravitreal and subtenon depot triamcinolone appear to provide at least temporary benefit in refractory CME as regards the improvement of visual acuity.

Cystoid Macular Edema Secondary to Paclitaxel Therapy

2019 ◽  
Vol 2 ◽  
pp. 1 ◽  
Author(s):  
Anibal Martin Folgar ◽  
Jorge Oscar Zarate
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Fluorescein Angiography ◽  
Macular Edema ◽  
Cystoid Macular Edema ◽  
Metastatic Breast ◽  
Breast Adenocarcinoma ◽  
Optical Coherence ◽  
Ophthalmoscopic Examination

We present a 57-year-old referred reduced visual acuity who was in treatment with paclitaxel for developing metastatic breast adenocarcinoma. Ophthalmoscopic examination, optical coherence tomography, and autofluorescence show the cystoid macular edema, but fluorescein angiography is normal, without leakage of dye in the late times. The patient responds well 8 weeks after stopping antineoplastic. Paclitaxel can cause cystoid macular edema and lifting a recovery both anatomical and functional of the macula.

Effect of Intravitreal Injection as a Primary Treatment in Cystoid Macular Edema after Cataract Surgery

2012 ◽  
Vol 53 (3) ◽  
pp. 428 ◽  
Author(s):  
Joo Yeon Kim ◽  
Joung Mok Kim ◽  
Young Ju Lew ◽  
Chul Gu Kim ◽  
Sung Won Cho ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Macular Edema ◽  
Intravitreal Injection ◽  
Cystoid Macular Edema ◽  
Primary Treatment

scholarly journals Subliminal Laser as Additional Therapy to Reduce Intravitreal Injection Number for the Patients with Macular Diseases

2020 ◽  
Vol 18 (1) ◽  
pp. 45-47
Author(s):  
Liene Muceniece ◽  
Dace Markevica
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Systemic Disease ◽  
Alternative Therapy ◽  
Treatment Method ◽  
Macular Thickness ◽  
Intravitreal Injections ◽  
Macular Diseases ◽  
Significant Difference ◽  
Additional Therapy

SummaryIntroductionIntravitreal injections have become one of the most performed surgical procedures in ophthalmology. There is a need to look for an effective alternative therapy for patients with anti-VEGF complications and systemic disease contraindications.Aim of the studyTo evaluate Subliminal laser effectiveness on reducing macular disease edema.Materials and methodsSubliminal laser treatment was done three times with three month intervals for patients with macular edema due to retinal diseases. On 1st, 3rd, 6th and 9th month visit the best corrected visual acuity, intraocular pressure, macular thickness and macular volume were registered.ResultsMean visual acuity before treatment was 0,52 (SD=0,31) that changed to 0,56 after the 9 month treatment (p>0,05). Mean central macular thickness from 326,12 μm reduced to 308,15 (p=0,76). Without significant difference, inner cycle volume changed from 1353,80 mm3 to 1297,57 mm3 (p=0,81) and outer cycle volume from 1179,4 mm3 to 1112,56 mm3 (p=0,51).ConclusionsSubliminal laser controls macular edema level and could be a solution for patients who cannot afford or are emotionally distressed by monthly intravitreal injections. This treatment method can be used as additional therapy to reduce the number of intravitreal injections.

Subthreshold micropulse yellow laser for the management of refractory cystoid macular edema consequent to complicated cataract surgery

2020 ◽  
pp. 112067212092800
Author(s):  
Tommaso Verdina ◽  
Cecilia Ferrari ◽  
Edoardo Valerio ◽  
Alberto Brombin ◽  
Andrea Lazzerini ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Macular Edema ◽  
Laser Treatment ◽  
Cystoid Macular Edema ◽  
Foveal Thickness ◽  
Corrected Visual Acuity ◽  
Complicated Cataract ◽  
Yellow Laser ◽  
Best Corrected Visual Acuity

Purpose: To report the safety and efficacy of subthreshold micropulse yellow laser of 577 nm for a complex case of refractory pseudophakic cystoid macular edema. Methods: A retrospective chart review of an interventional case report of three subthreshold micropulse yellow laser interventions for refractory pseudophakic cystoid macular edema. Patient: A 77-year-old healthy female underwent pseudoexfoliative cataract surgery complicated by posterior capsule rupture and sulcus intraocular lens implantation. After 3 months, she required a scleral fixation of the same lens, due to a lack of capsular support and decentration of the intraocular lens. One month later, she experienced a severe pseudophakic cystoid macular edema (foveal thickness of 399 µm and best-corrected visual acuity of 20/80 Snellen). The condition was refractory to conventional treatments prior to subthreshold micropulse yellow laser interventions, including non-steroidal anti-inflammatory eye drops, topical steroids, oral indomethacin and three sub-Tenon’s triamcinolone injections, attempted over a 14-month period. Results: Subthreshold micropulse yellow laser treatment was performed and immediate resolution was achieved and maintained for 2 months. Two cases of edema relapse were observed at 3 months from initial laser treatment and again at 4 months from the second laser treatment. Final patient’s follow-up at 6 months from the third laser treatment evidenced the absence of edema, improved visual acuity (foveal thickness of 265 µm/best-corrected visual acuity of 20/30 Snellen) and the absence of complications. Conclusions: Subthreshold micropulse yellow laser seems to be a safe and effective treatment for short-term resolution of refractory pseudophakic cystoid macular edema after complicated cataract surgery and represents a useful alternative to expensive and invasive therapies. A trend towards a longer duration of edema resolution with every subthreshold micropulse yellow laser repetition was observed.

scholarly journals CHANGES IN VISUAL ACUITY AND FOVEAL PHOTORECEPTOR INTEGRITY IN EYES WITH CHRONIC CYSTOID MACULAR EDEMA ASSOCIATED WITH RETINAL VEIN OCCLUSION

Retina ◽  
2012 ◽  
Vol 32 (4) ◽  
pp. 792-798 ◽  
Author(s):  
Yumiko Kurashige ◽  
Akitaka Tsujikawa ◽  
Tomoaki Murakami ◽  
Kazuaki Miyamoto ◽  
Ken Ogino ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Cystoid Macular Edema ◽  
Vein Occlusion

scholarly journals A Case of Diabetic Macular Edema with Prominent Chorioretinal Folds

2017 ◽  
Vol 8 (1) ◽  
pp. 163-169
Author(s):  
Takaki Sato ◽  
Ryohsuke Kohmoto ◽  
Masanori Fukumoto ◽  
Seita Morishita ◽  
Daisaku Kimura ◽  
...  
Keyword(s):  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Cystoid Macular Edema ◽  
Surrounding Tissue ◽  
Uncontrolled Hypertension ◽  
Vitreous Surgery ◽  
Antivascular Endothelial Growth Factor ◽  
Subtenon Injection ◽  
Endothelial Growth Factor ◽  
Chorioretinal Folds

Purpose: To report a case of diabetic macular edema with prominent chorioretinal folds. Case Report: This study involved a 55-year-old male with untreated bilateral diabetic retinopathy who had undergone cataract surgery at another clinic. Following that surgery, diabetic macular edema rapidly exacerbated, accentuating marked cystoid macular edema and radial chorioretinal folds in the macula. Investigation of his medical history revealed that in addition to diabetes, he had uncontrolled hypertension and severe diabetic nephropathy. Vitreous surgery was performed on both eyes due to a resistance to a subtenon injection of triamcinolone acetonide or intravitreal injection of an antivascular endothelial growth factor agent. After surgery, the macular edema and chorioretinal folds showed a tendency towards improvement. Thereafter, kidney transplant surgery was performed for renal failure, and a mild tendency of chorioretinal folds was observed. Conclusion: In the case presented in this study, we observed remarkable cystoid macular edema in the fovea centralis and theorize that distortion with the surrounding tissue might have occurred, thus leading to the formation of chorioretinal folds around the macula.

scholarly journals Comparative characteristics of the outcomes of the use of multidirectional intravitreal pharmacotherapy in the treatment of diabetic macular edema

2021 ◽  
pp. 39-45
Author(s):  
М.М. Bikbov ◽  
◽  
K.I. Kudoyarova ◽  
R.M. Zainullin ◽  
T.R. Gilmanshin ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Intravitreal Injection ◽  
Diabetic Macular Edema ◽  
Angiogenesis Inhibitor ◽  
Standard Technique ◽  
Macular Area ◽  
Dexamethasone Implant ◽  
Biodegradable Implant ◽  
Inflammatory Reactions

Purpose. To conduct a comparative analysis of the effectiveness of intravitreal injection of dexamethasone-containing implant and aflibercept in macular edema in patients with diabetes mellitus. Material and methods. The study involved 80 patients (80 eyes) with macular edema. The group 1 included 38 patients (38 eyes) who underwent a single intravitreal injection of dexamethasone-containing biodegradable implant «Ozurdex» in a dose of 0.7 mg according to the standard technique. In the group 2, 42 patients (42 eyes) received 5 loading doses of aflibercept with an interval of one month. All patients underwent monthly spectral optical coherence tomography (OCT) of the macular area, as well as visometry and tonometry during the observation period. Results. One month after intravitreal injection of the studied drugs in both groups, no inflammatory reactions were detected in any case. According to OCT data, cystic edema of the macular area with a tendency to decrease the thickness in the fovea was preserved. After treatment with aflibercept, the average retinal thickness in the macula was 186.4±15.1 µm, and visual acuity averaged 0.48±0.05 in 85.7% of patients. During therapy with intravitreal injection of Ozurdex, an increase in visual acuity was noted in 89.4% of patients. Conclusion. This study found that intravitreal pharmacotherapy with an angiogenesis blocker and a dexamethasone implant in patients with diabetic macular edema are comparable in its effectiveness – 85.7 and 89.4% respectively. If systematic anti-angiogenesis therapy is not possible for a number of reasons, it is advisable to use a prolonged dexamethasone implant. Key words: macular edema, intravitreal pharmacotherapy, angiogenesis inhibitor, implant with dexamethasone.

scholarly journals Cystoid Macular Edema: Causes, Diagnosis and Treatment

2015 ◽  
Vol 3 (3) ◽  
pp. 131-139 ◽  
Author(s):  
Noelia Bravo-Alcobendas ◽  
Joseba Zulueta ◽  
Elena Salobrar-García ◽  
Juan J Salazar ◽  
José M Ramírez
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Cystoid Macular Edema ◽  
Retinal Thickness ◽  
Retinal Dystrophy ◽  
Standard Technique ◽  
Blood Retinal Barrier ◽  
Fluid Extravasation ◽  
Intraocular Tumors ◽  
Inflammatory Drugs

The purpose of this paper is to conduct a review of studies on cystoid macular edema published in the last seven years. Cystoid macular edema is a major cause of loss of visual acuity. It is the final common pathway of many diseases and can be caused by numerous processes including inflammatory, vascular, adverse drug reactions, retinal dystrophy or intraocular tumors. These processes disrupt the blood-retinal barrier, with fluid extravasation to the macular parenchyma. Imaging tests are essential for both detection and monitoring of this pathology. Fluorescein angiography and autofluorescence show the leakage of liquid from perifoveal vessels into the tissue where it forms cystic spaces. Optical coherence tomography is currently the gold standard technique for diagnosis and monitoring. This allows objective measurement of retinal thickness, which correlates with visual acuity and provides more complete morphological information. Based on the underlying etiology, the therapeutic approach can be either surgical or medical with anti-inflammatory drugs. We found that disruption of the blood-retinal barrier for various reasons is the key point in the pathogenesis of cystoid macular edema, therefore we believe that studies on its treatment should proceed on this path.

scholarly journals Incidence of clinical and subclinical macular edema in patients submitted to phacoemulsification in a university health service

2020 ◽  
Vol 45 (Suppl.3) ◽  
pp. e020103
Author(s):  
Luciana de Almeida ◽  
Glaucia Luciano da Veiga ◽  
Fernando Martins de Oliveira ◽  
Fernando Luiz Affonso Fonseca ◽  
Vagner Loduca Lima ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Health Service ◽  
Macular Edema ◽  
Cystoid Macular Edema ◽  
Diagnostic Method ◽  
Prostaglandin Analogue ◽  
Multicenter Studies ◽  
Clinically Significant ◽  
Low Incidence

Introduction: The incidence of cystoid macular edema (CME) after cataract surgery varies substantially and depending on the diagnostic method used. In addition, other factors that influence the incidence of CME are the technique of surgery and the associated comorbidities. Objective: The aim of the present study was to evaluate the incidence of EMC after uncomplicated phacoemulsification surgery, using the spectral domain optical coherence tomography (OCT). Methods: The incidence of sub-clinical and clinical CME was evaluated in 14 patients who underwent uncomplicated phacoemulsification surgery, using OCT before the surgical procedure and after seven and 28 days after it. The volunteers could not use a prostaglandin analogue or present any retinopathy that compromised visual acuity. Results: The incidence of clinically significant CME was 6.4%, however retinal thickening by OCT was observed in all patients in the fourth postoperative week. Regarding gender and laterality, the percentages were similar. Conclusion: In this study, we obtained a low incidence of EMC in patients assisted at this center, corroborating multicenter studies.

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