Comparison of evaluation parameters in the retinal layer between diabetic cystoid macular edema and postoperative cystoid macular edema after cataract surgery based on a hierarchical approach

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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Effect of Controlled Continuous Positive Intraocular Pressure by Anterior Chamber Maintainer during Cataract Surgery on the Incidence of Pseudophakic Cystoid Macular Edema

Developments in Ophthalmology - Evolution of Microsurgery ◽

10.1159/000419914 ◽

2015 ◽

pp. 119-121 ◽

Cited By ~ 5

Author(s):

M. Blumenthal ◽

I. Ashkenazi ◽

E. Bartov ◽

A. Hirsh

Keyword(s):

Intraocular Pressure ◽

Cataract Surgery ◽

Macular Edema ◽

Anterior Chamber ◽

Cystoid Macular Edema

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Cystoid Macular Edema Following Cataract Surgery

Archives of Ophthalmology ◽

10.1001/archopht.1988.01060140040018 ◽

1988 ◽

Vol 106 (7) ◽

pp. 894-895 ◽

Cited By ~ 11

Author(s):

L. M. Jampol

Keyword(s):

Cataract Surgery ◽

Macular Edema ◽

Cystoid Macular Edema

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4431 Utilization of swept source optical coherence tomography to optimize characterization of cystoid macular edema in preterm infants

Journal of Clinical and Translational Science ◽

10.1017/cts.2020.320 ◽

2020 ◽

Vol 4 (s1) ◽

pp. 103-104

Author(s):

Kai Seely ◽

Shwetha Mangalesh ◽

Katrina Winter ◽

Vincent Tai ◽

Du Tran-Viet ◽

...

Keyword(s):

Logistic Regression ◽

Macular Edema ◽

Preterm Infants ◽

Cystoid Macular Edema ◽

High Speed ◽

Retinal Layer ◽

Swept Source ◽

Intensive Care Nursery ◽

Eye Exams

OBJECTIVES/GOALS: The goal of this study is to evaluate and optimize the characterization of cystoid macular edema (CME) using an investigational swept source (SS)-OCT system. Our knowledge of CME in preterm infants is limited; optimizing its characterization is a critical step in understanding its impact on vision. METHODS/STUDY POPULATION: In this IRB-approved protocol, 118 preterm infants were imaged in the Duke intensive care nursery (ICN) with a novel lightweight, hand-held, high-speed, SS-OCT system following routine clinical eye exams. SS-OCT images were deidentified, automatically segmented using custom software (DOCTRAP), measured for several retinal layer thicknesses, and reviewed by masked expert graders for the presence and severity of CME. Reliability of SS-OCT measures will be assessed, and the association between CME status and retinal layer thicknesses will be calculated using logistic regression modeling. RESULTS/ANTICIPATED RESULTS: The prevalence of CME overall and by severity will be calculated. The distribution of several retinal layer thicknesses will be reported and compared by infant CME status and, when edema is present, by CME severity. Reproducibility and repeatability will be reported for objective variables, and intra-grader and inter-grader agreement will be reported for subjective variables. Multivariate logistic regression coefficients and odds ratios will be calculated for each retinal layer thickness variable. DISCUSSION/SIGNIFICANCE OF IMPACT: This study will use a novel SS-OCT system to identify retinal thickness measures that may be objective markers of CME status. This will refine the characterization of CME and provide a framework for correlating CME with functional outcomes like visual acuity. CONFLICT OF INTEREST DESCRIPTION: SC and CT have unlicensed patents on relevant technologies. CT receives royalties from Alcon and Hemosonics and consultation fees from EMMES.

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