Faculty Opinions recommendation of Quantitative effect of subretinal fluid and intraretinal edema on visual acuity in uveitic cystoid macular edema.

Abstract Background The effect of subretinal fluid (SRF) in uveitic cystoid macular edema (CME) is not fully understood. This study evaluates the quantitative effect of SRF and intraretinal thickness on visual acuity in eyes with uveitic CME. We separately measured SRF and intraretinal area on Optical Coherence Tomography (OCT) to determine the associations of each component with visual acuity and response to treatment. Main text Medical records were reviewed of patients with CME presenting to the University of Colorado uveitis clinic from January 2012 to May 2019. All available OCTs were reviewed to classify eyes as either having only CME or CME with SRF. Intraretinal area was manually measured using Image J along the central 1-mm section of B-scan OCT spanning from the internal limiting membrane to the outer most portion of the outer retina including both cysts and retinal tissue. SRF cross-sectional area was measured spanning from the outermost portion of the outer retina to retinal pigment epithelium. Response to treatment was assessed one to four months after presentation. Eyes with CME secondary to structural or non-inflammatory causes were excluded. Forty-seven (50.5%) eyes had CME alone and 46 (49.5%) eyes had SRF with CME. Measured SRF cross-sectional area was not associated (p = 0.21) with LogMAR at presentation. Conversely, intraretinal area was strongly correlated with visual acuity in eyes with SRF (p < 0.001) and without SRF (p < 0.001). Following treatment, there was a significant decrease in intraretinal area for both groups (p < 0.001), with a larger decrease in the SRF group compared to the non-SRF group (p = 0.001). Similarly, logMAR improved in both groups (p = 0.008 for SRF eyes and p = 0.005 for non-SRF eyes), but the change was more prominent in the SRF group (p = 0.06). Conclusions There was no direct association observed between the amount of SRF and visual acuity. In contrast, increased intraretinal area was significantly associated with decreased visual acuity. This relationship between intraretinal thickening and visual acuity may explain differences observed in response to treatment between SRF and non-SRF eyes, with a larger decrease in the intraretinal cross-sectional area in SRF eyes associated with a greater improvement in logMAR visual acuity.

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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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Retinal Vasculitis Associated With Dermatomyositis Treated With Intravenous Steroids

Journal of VitreoRetinal Diseases ◽

10.1177/24741264211018960 ◽

2021 ◽

pp. 247412642110189

Author(s):

Austen N. Knapp ◽

Jawad I. Arshad ◽

Daniel F. Martin ◽

Rula Hajj-Ali ◽

Kimberly Baynes ◽

...

Keyword(s):

Visual Acuity ◽

Macular Edema ◽

Retinal Vasculitis ◽

Subretinal Fluid ◽

Retrospective Case ◽

Hand Motion ◽

Frosted Branch Angiitis ◽

Intravenous Steroids

Purpose: This work aims to present treatment and long-term follow-up of a 31-year-old woman with dermatomyositis who presented with hemorrhagic retinal vasculitis and macular edema. Methods: A retrospective case report is presented. Results: A 31-year-old woman with dermatomyositis treated with systemic immunosuppression was evaluated for acute, reduced vision. Best-corrected visual acuity was hand motion in the right eye and 20/200 in the left eye. Fundus examination revealed diffuse intraretinal hemorrhages, cotton-wool spots, and vascular sheathing with a frosted branch angiitis–like appearance. Optical coherence tomography revealed significant macular edema and subretinal fluid that quickly resolved after admission and treatment with intravenous steroids. Multimodal imaging at 7-year follow-up disclosed long-term sequelae including peripheral nonperfusion and retinal neovascularization. Conclusions: When vasculitis associated with dermatomyositis is treated aggressively with intravenous steroids at initial presentation, good visual acuity outcomes can be achieved, but long-term consequences of retinal nonperfusion and neovascularization persist.

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Some aspects of diagnosis and treatment of a сircumscribed form of choroidal hemangioma complicated by macular edema

Modern technologies in ophtalmology ◽

10.25276/2312-4911-2021-3-240-246 ◽

2021 ◽

pp. 240-246

Author(s):

J.A. Magaramov ◽

◽

R.A. Loginov ◽

O.B. Klepinina ◽

◽

...

Keyword(s):

Visual Acuity ◽

Optic Nerve ◽

Macular Edema ◽

Subretinal Fluid ◽

Diagnostic Methods ◽

Treatment Results ◽

Transpupillary Thermotherapy ◽

Choroidal Hemangioma ◽

Nasal Side ◽

Intraretinal Cysts

Introduction. The interest are rare cases of a сircumscribed choroidal hemangioma located juxtapapillary (JP) on the nasal side of the optic nerve disc (OND) and complicated by macular edema. Purpose. Studying the possibility of timely diagnosis and evaluating the effectiveness of treatment of a сircumscribed choroidal hemangioma complicated by macular edema. Material and methods. A retrospective analysis of the diagnostics and treatment results of 5 patients (5 eyes) with JP сircumscribed choroidal hemangioma, localized on the nasal side of the optic disc, complicated by macular edema, was carried out. Results. As a result, in all patients, already 1 month after the session of selective laser transpupillary thermotherapy (TTT), an increase in visual acuity and quality was observed, which was accompanied by pronounced resorption of intraretinal cysts and / or subretinal fluid in the macula. Conclusion. The purposeful use of modern diagnostic methods and the use of a sparing method of laser TTT makes it possible to identify and cure patients with CPCH complicated by macular edema without loss of visual functions. Key words: сircumscribed choroidal hemangioma, selective transpupillary thermotherapy, cystic macular edema.

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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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Visual loss related to macular subretinal fluid and cystoid macular edema in HIV-related optic neuropathy

International Ophthalmology ◽

10.1007/s10792-012-9575-8 ◽

2012 ◽

Vol 32 (4) ◽

pp. 405-408 ◽

Cited By ~ 3

Author(s):

David Gautier ◽

Valérie Rabier ◽

Ghislaine Jallet ◽

Dan Milea

Keyword(s):

Macular Edema ◽

Optic Neuropathy ◽

Cystoid Macular Edema ◽

Visual Loss ◽

Subretinal Fluid

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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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