Publication:
Cystoid Macular Edema: Causes, Diagnosis and Treatment

Loading...
Thumbnail Image
Full text at PDC
Publication Date
2015-09
Advisors (or tutors)
Editors
Journal Title
Journal ISSN
Volume Title
Publisher
International Journal of Medical Students
Citations
Google Scholar
Research Projects
Organizational Units
Journal Issue
Abstract
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.
Description
En Open Access en la web del editor. Submission: Mar 17, 2015 Acceptance: Aug 22, 2015 Publication Dec 31, 2015
UCM subjects
Keywords
Citation
1. Irvine SR. A newly defined vitreous syndrome following cataract surgery: Interpreted according to recent concepts of the structure of the vitreous, the seventh francis I. proctor lecture. Am J Ophthalmol. 1953 May;36(5):599-619. 2. Cho H, Madu A. Etiology and treatment of the inflammatory causes of cystoid macular edema. J Inflamm Res. 2009 Oct;2:37-43. 3. Zur D, Fischer N, Tufail A, Mones J, Loewenstein A. Postsurgical cystoid macular edema. Eur J Ophthalmol. 2011 Aug;21 Suppl 6:S62-8. 4. Bergman M, Laatikainen L. Cystoid macular oedema after complicated cataract surgery and implantation of an anterior chamber lens. Acta Ophthalmol. 1994 Apr;72(2):178-80. 5. Johnson MW. Etiology and treatment of macular edema. Am J Ophthalmol. 2009 Jan;147(1):11-21. e1. 6. Bradford DJ, Wilkinson C, Bradford JR RH. Cystoid macular edema following extracapsular cataract extraction and posterior chamber intraocular lens implantation. Retina. 1988 Feb;8(3):161-4. 7. Rotsos TG, Moschos MM. Cystoid macular edema. Clin Ophthalmol. 2008 Dec;2(4):919-30. 8. Sevim MS, Sanisoglu H, Turkyilmaz K. Intravitreal triamcinolone acetonide versus pars plana vitrectomy for pseudophakic cystoid macular edema. Curr Eye Res. 2012 Aug;37(12):1165-10. 9. Miyake K, Ota I, Miyake G, Numaga J. Nepafenac 0.1% versus fluorometholone 0.1% for preventing cystoid macular edema after cataract surgery. J Cataract Refract Surg. 2011 Sep;37(9):1581-8. 10. Kessel L, Tendal B, Jørgensen KJ, Erngaard D, Flesner P, Andresen JL, et al. Post-cataract prevention of inflammation and macular edema by steroid and nonsteroidal anti-inflammatory eye drops: A systematic review. Ophthalmology. 2014 Oct;121(10):1915-24 11. Tranos PG, Tsaousis KT, Vakalis AN, Asteriades S, Pavesio CE. Long-term follow-up of inflammatory cystoid macular edema. Retina. 2012 Sep;32(8):1624-8. 12. Ouyang Y, Keane PA, Sadda SR, Walsh AC. Detection of cystoid macular edema with three-dimensional optical coherence tomography versus fluorescein angiography. Invest Ophthalmol Vis Sci. 2010 Oct;51(10):5213-8. 13. Brar M, Yuson R, Kozak I, Mojana F, Cheng L, Bartsch DU, et al. Correlation between morphologic features on spectral-domain optical coherence tomography and angiographic leakage patterns in macular edema. Retina. 2010 Mar;30(3):383-9. 14. Pelosini L, Hull CC, Boyce JF, McHugh D, Stanford MR, Marshall J. Optical coherence tomography may be used to predict visual acuity in patients with macular edema. Invest Ophthalmol Vis Sci. 2011 Apr;52(5):2741-8. 15. Fu A, Bui A, Roe R, Ahmed I, Ai E. Cystoid macular edema. In: Yanoff M DJ, ed. Ophtalmology. ; 2009:696-701. 16. Manousaridis K, Gupta R. Risperidone-related bilateral cystoid macular oedema. Garefe's Arch Clin Exp Ophtalmol. 2013 Mar;251(3):1037-8. 17. Telander DG, Sarraf D. Cystoid macular edema with docetaxel chemotherapy and the fluid retention syndrome. Semin Ophthalmol. 2007 Jul-Sep;22(3):151-3. 18. Joshi MM, Garretson BR. Paclitaxel maculopathy. Arch Ophthalmol. 2007 May;125(5):709-10. 19. Ryan EH,Jr, Han DP, Ramsay RC, Cantrill HL, Bennett SR, Dev S, et al. Diabetic macular edema associated with glitazone use. Retina. 2006 May-Jun;26(5):562-70. 20. Charalampidou S, Nolan J, Beatty S. The natural history of tractional cystoid macular edema. Retina. 2012 Nov-Dec;32(10):2045-51. 21. Jun JJ, Duker JS, Baumal CR, McCabe F, Reichel E, Rogers AH, et al. Cystoid macular edema without macular thickening: A retrospective optical coherence tomographic study. Retina. 2010 Jun;30(6):917-23. 22. Al Faran A, Mousa A, Al Shamsi H, Al Gaeed A, Ghazi NG. Spectral domain optical coherence tomography predictors of visual outcome in diabetic cystoid macular edema after bevacizumab injection. Retina. 2014 Jun;34(6):1208-15. 23. Kim JT, Lee DH, Joe SG, Kim JG, Yoon YH. Changes in choroidal thickness in relation to the severity of retinopathy and macular edema in type 2 diabetic patients. Invest Ophthalmol Vis Sci. 2013 May;54(5):3378-84. 24. Ebrahimiadib N, Riazi-Esfahani M. Autofluorescence imaging for diagnosis and follow-up of cystoid macular edema. J Ophthalmic Vis Res. 2012 Jul;7(3):261-7. 25. Flach AJ. Topical nonsteroidal antiinflammatory drugs in ophthalmology. Int Ophthalmol Clin. 2002 Winter;42(1):1-11. 26. Yilmaz T, Cordero-Coma M, Gallagher M. Ketorolac therapy for the prevention of acute pseudophakic cystoid macular edema: A systematic review. Eye. 2011 Feb;26(2):252-8. 27. Burnett J, Tessler H, Isenberg S, Tso MO. Double-masked trial of fenoprofen sodium: Treatment of chronic aphakic cystoid macular edema. Ophthalmic Surg. 1983 Feb;14(2):150-2. 28. Ramezani A, Fard Esmaeilpour N, Eskandari A, Rabbanikhah Z, Soheilian R, Soheilian M. Intravitreal diclofenac for refractory uveitic cystoid macular edema. J Ophthalmic Vis Res. 2013 Jan;8(1):47-52. 29. Shelsta HN, Jampol LM. Pharmacologic therapy of pseudophakic cystoid macular edema: 2010 update. Retina. 2011 Jan;31(1):4-12. 30. Abe T, Hayasaka S, Nagaki Y, Kadoi C, Matsumoto M, Hayasaka Y. Pseudophakic cystoid macular edema treated with high-dose intravenous methylprednisolone. J Cataract Refract Surg. 1999 Sep;25(9):1286-8. 31. Wakefield D, McCluskey P, Penny R. Intravenous pulse methylprednisolone therapy in severe inflammatory eye disease. Arch Ophthalmol. 1986 Jun;104(6):847-51. 32. Hainsworth DP, Pearson PA, Conklin JD, Ashton P. Sustained release intravitreal dexamethasone. J Ocul Pharmacol Ther. 1996 Spring;12(1):57-63. 33. Jaffe GJ, Ben-nun J, Guo H, Dunn JP, Ashton P. Fluocinolone acetonide sustained drug delivery device to treat severe uveitis. Ophthalmology. 2000 Nov;107(11):2024-33. 34. Koutsandrea C, Moschos MM, Brouzas D, Loukianou E, Apostolopoulos M, Moschos M. Intraocular triamcinolone acetonide for pseudophakic cystoid macular edema: Optical coherence tomography and multifocal electroretinography study. Retina. 2007 Feb;27(2):159-64. 35. Shen BY, Punjabi OS, Lowder CY, Sears JE, Singh RP. Early treatment response of fluocinolone (retisert) implantation in patients with uveitic macular edema: An optical coherence tomography study. Retina. 2013 Apr;33(4):873-7. 36. Jonas JB, Kreissig I, Söfker A, Degenring RF. Intravitreal injection of triamcinolone for diffuse diabetic macular edema. Arch Ophthalmol. 2003 Jan;121(1):57-61. 37. Avitabile T, Longo A, Reibaldi A. Intravitreal triamcinolone compared with macular laser grid photocoagulation for the treatment of cystoid macular edema. Am J Ophthalmol. 2005 Oct;140(4):695-702. 38. Loewenstein A, Goldstein M. Intravitreal triamcinolone acetonide for diabetic macular edema. IMAJ. 2006 Jun;8(6):426. 39. Androudi S, Letko E, Meniconi M, Papadaki T, Ahmed M, Foster CS. Safety and efficacy of intravitreal triamcinolone acetonide for uveitic macular edema. Ocul Immunol Inflamm. 2005 Apr-Jun;13(2-3):205-12. 40. Jaffe GJ, Martin D, Callanan D, et al. Fluocinolone acetonide implant (retisert) for noninfectious posterior uveitis: Thirty-four–week results of a multicenter randomized clinical study. Ophthalmology. 2006 Jun;113(6):1020-7. 41. Coma MC, Sobrin L, Onal S, Christen W, Foster CS. Intravitreal bevacizumab for treatment of uveitic macular edema. Ophthalmology. 2007 Aug;114(8):1574-1579. 42. Jabs DA, Rosenbaum JT, Foster CS, Holland GN, Jaffe GJ, Louie JS, et al. Guidelines for the use of immunosuppressive drugs in patients with ocular inflammatory disorders: Recommendations of an expert panel. Am J Ophthalmol. 2000 Oct;130(4):492-513. 43. Kita M, Marmor MF. Effects on retinal adhesive force in vivo of metabolically active agents in the subretinal space. Invest Ophthalmol Vis Sci. 1992 May;33(6):1883-7. 44. Fishman GA, Gilbert LD, Fiscella RG, Kimura AE, Jampol LM. Acetazolamide for treatment of chronic macular edema in retinitis pigmentosa. Arch Ophthalmol. 89 Oct;107(10):1445-52. 45. Cunningham ET Jr, Adamis AP, AltaweelM, Aiello LP, Bressler NM, D'Amico DJ, et al; Macugen Diabetic Retinopathy Study Group. A phase II randomized double-masked trial of pegaptanib, an Anti–Vascular endothelial growth factor aptamer, for diabetic macular edema. Ophthalmology. 2005 Oct;112(10):1747-57. 46. Mitropoulos PG, Chatziralli IP, Peponis VG, Drakos E, Parikakis EA. Intravitreal ranibizumab for the treatment of irvine-gass syndrome. Ocul Immunol Inflamm. 2015 Jun; 23(3):225-31 47. Lott MN, Schiffman JC, Davis JL. Bevacizumab in inflammatory eye disease. Am J Ophthalmol. 2009 Nov;148(5):711-7. 48. Ghasemi Falavarjani K, Parvaresh MM, Modarres M, Hashemi M, Samiy N. Intravitreal bevacizumab for pseudophakic cystoid macular edema; a systematic review. J Ophthalmic Vis Res. 2012 Jul;7(3):235-9. 49. Moschos MM, Moschos M. Intraocular bevacizumab for macular edema due to CRVO. A multifocal-ERG and OCT study. Doc Ophthalmol. 2008 Mar;116(2):147-52. 50. Iturralde D, Spaide RF, Meyerle CB, Klancnik JM, Yannuzzi LA, Fisher YL, et al. Intravitreal bevacizumab (avastin) treatment of macular edema in central retinal vein occlusion: A short-term study. Retina. 2006 Mar;26(3):279-84. 51. Central Vein Occlusion Study Group. Evaluation of grid pattern photocoagulation for macular edema in central vein occlusion: The central vein occlusion study group M report. Ophthalmology. 1995 Oct;102(10):1425-33. 52. Branch Vein Occlusion Study Group. Argon laser photocoagulation for macular edema in branch vein occlusion. Am J Ophthalmol. 1984 Sep;98(3):271-82. 53. Early Treatment Diabetic Retinopathy Study Research Group. Techniques for scatter and local photocoagulation treatment of diabetic retinopathy: Early treatment diabetic retinopathy study report no. 3. Int Ophthalmol Clin. 1987 Winter;27(4):254-64. 54. Harbour JW, Smiddy WE, Rubsamen PE, Murray TG, Davis JL, Flynn HW. Pars plana vitrectomy for chronic pseudophakic cystoid macular edema. Am J Ophthalmol. 1995 Sep;120(3):302-7. 55. Nasrallah FP, Jalkh AE, Van Coppenolle F, et al. The role of the vitreous in diabetic macular edema. Ophthalmology. 1988 Oct;95(10):1335-9. 56. Packer M, Lowe J, Fine H. Incidence of acute postoperative cystoid macular edema in clinical practice. J Cataract Refract Surg. 2012 Dec;38(12):2108-11.
Collections