Cystoid macular edema after phacoemulsification: risk factors and effect on visual acuity

Purpose. To analyze risk factors associated with poor visual outcome in patients with ocular sarcoidosis. Methods. In this retrospective study, charts of 44 patients with uveitis and biopsy-proven sarcoidosis were reviewed. Ocular parameters evaluated were as follows: location, type of uveitis, visual acuity, presence of posterior synechia, iris nodules, vitritis, snowballs, chorioretinal lesions, retinal vasculitis, papillitis, macular edema, cataract, and glaucoma. Final visual acuity of the worst-seeing eye at last follow-up was the outcome considered in univariable and multivariable analyses. Visual acuity of the worst-seeing eye was stratified into 2 categories according to the threshold 20/50 (≤20/50 and >20/50). Results. A total of 44 patients with bilateral uveitis were studied. The majority of patients presented with panuveitis (52%), granulomatous type (61%), posterior synechia (62%). The most frequent vision-threatening complications were cystoid macular edema (56%) and cataract (56%). The median best-corrected visual acuity in the worst-seeing eye at presentation and at end of follow-up was respectively 0.4 (interquartile range [IQR] 0.26–0.80) and 0.63 (IQR 0.36–1.00). At univariable analysis, the presence of iris nodules (p=0.049), cystoid macular edema (p=0.007), and cataract (p=0.007) were clinically significant conditions for a visual outcome of 20/50 or worse in the worst-seeing eye. In multivariable analysis, cystoid macular edema (p=0.034) was the only statistically significant predictor associated with unfavorable visual outcome. Conclusions. In this study, we attempted to find risk factors related to poor visual outcome in patients with ocular sarcoidosis. The results suggest that only the presence of cystoid macular edema was significantly associated with worst visual outcome.

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Clinical Characteristics Associated with the Development of Cystoid Macular Edema in Patients with Cytomegalovirus Retinitis

Microorganisms ◽

10.3390/microorganisms9061114 ◽

2021 ◽

Vol 9 (6) ◽

pp. 1114

Author(s):

Hye-Ji Kwon ◽

Gisung Son ◽

Joo-Yong Lee ◽

June-Gone Kim ◽

Yoon-Jeon Kim

Keyword(s):

Risk Factors ◽

Optical Coherence Tomography ◽

Visual Acuity ◽

Macular Edema ◽

Acute Phase ◽

Cystoid Macular Edema ◽

Clinical Characteristics ◽

Development Zone ◽

Cmv Retinitis ◽

Different Characteristics

We evaluated the incidence and characteristics of eyes with cytomegalovirus (CMV) retinitis according to the occurrence of cystoid macular edema (CME) and identified the risk factors of its occurrence. Patients diagnosed with CMV retinitis and examined using optical coherence tomography were classified according to the development of CME. The CME group was further divided according to the presence of active retinitis at the time of CME development. The demographics, serologic findings, ophthalmic presentations, ocular treatments, and visual prognosis were compared. CME was identified in 25 eyes (17 eyes with active retinitis and 8 eyes with inactive retinitis) out of the 67 eyes with CMV retinitis. Visual acuity was worse in the CME group than in the non-CME group. The CME group had longer CMV viremia duration, zone 1 involvement, and larger extent of CMV retinitis. While CME with concurrent active retinitis developed in eyes with direct foveal involvement of retinitis in the acute phase and required more ganciclovir injections after CME development, CME without active retinitis developed in eyes with larger extents of involvement and more intravitreal ganciclovir injections before CME development. Zone 1 involvement and longer CMV viremia duration were independently associated with the occurrence of CME. CME, which caused visual deterioration, developed in considerable patients with CMV retinitis and had different characteristics according to the presence of active retinitis.

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Cystoid Macular Edema Secondary to Paclitaxel Therapy

Latin American Journal of Ophthalmology ◽

10.25259/lajo-2-2018 ◽

2019 ◽

Vol 2 ◽

pp. 1 ◽

Cited By ~ 3

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.

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Risk Factors for Cystoid Macular Edema After Descemet Membrane Endothelial Keratoplasty

Cornea ◽

10.1097/ico.0000000000001950 ◽

2019 ◽

Vol 38 (7) ◽

pp. 820-824 ◽

Cited By ~ 7

Author(s):

Satoru Inoda ◽

Takahiko Hayashi ◽

Hidenori Takahashi ◽

Itaru Oyakawa ◽

Hideaki Yokogawa ◽

...

Keyword(s):

Risk Factors ◽

Macular Edema ◽

Cystoid Macular Edema ◽

Endothelial Keratoplasty ◽

Descemet Membrane Endothelial Keratoplasty ◽

Descemet Membrane

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

European Journal of Ophthalmology ◽

10.1177/1120672120928008 ◽

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.

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

Retina ◽

10.1097/iae.0b013e3182278b98 ◽

2012 ◽

Vol 32 (4) ◽

pp. 792-798 ◽

Cited By ~ 8

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

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Cystoid Macular Edema: Causes, Diagnosis and Treatment

International Journal of Medical Students ◽

10.5195/ijms.2015.134 ◽

2015 ◽

Vol 3 (3) ◽

pp. 131-139 ◽

Cited By ~ 2

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.

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

ABCS Health Sciences ◽

10.7322/abcshs.2020s03.1850 ◽

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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Effects of intravitreal aflibercept (Eylea) in the treatment of bilateral cystoid macular edema in retinitis pigmentosa: A case report

Medicinski pregled ◽

10.2298/mpns1906171d ◽

2019 ◽

Vol 72 (5-6) ◽

pp. 171-175

Author(s):

Sofija Davidovic ◽

Sanja Jovanovic ◽

Nikola Babic ◽

Aleksandar Miljkovic ◽

Desanka Grkovic ◽

...

Keyword(s):

Visual Acuity ◽

Retinitis Pigmentosa ◽

Macular Edema ◽

Cystoid Macular Edema ◽

Intravitreal Therapy ◽

Short Period ◽

Patient Reported ◽

Intravitreal Aflibercept ◽

Repeated Doses ◽

The Right

Introduction. The aim of the study was to evaluate the effects of intravireal injections of aflibercept (Eylea) on bilateral cystoid macular edema in a patient with retinitis pigmentosa. Material and Methods. A 17-year-old man presented with a moderate bilateral decrease of visual acuity (0.3) and ocular examination was performed. Optical coherence tomography imaging was performed and cystoid macular edema was detected in both eyes. Due to disease progression in a short period of time, intravitreal repeated injections of aflibercept (Eylea) were initiated according to recent clinical reports. Results. The initial values of cystoid macular edema before intravitreal therapy were 248 ?m in the right and 237 ?m in the left eye; they increased slowly in next several weeks. Four bilateral repeated doses of intravitreal aflibercept injections at 6-week intervals were given in local anesthesia. The patient reported a subjective improvement, and his visual acuity was 4/10 in both eyes. Objectively, the macular edema decreased at week 24, reaching 173 ?m in the right and 188 ?m in the left eye. Conclusion. There are few literature reports on the possible effects of intravitreal aflibercept injections in the treatment of retinitis pigmentosa-related cystoid macular edema. In our study, bilateral macular edema in a patient with retinitis pigmentosa has improved significantly after four consecutive treatments. Further studies are necessary with a larger sample size and longer follow-up period to obtain information on the role and safety of intravitreal drugs for cystoid macular edema in retinitis pigmentosa. This article has been corrected. Link to the correction <a href="http://dx.doi.org/10.2298/MPNS1910326E">10.2298/MPNS1910326E</a>

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