- One of the most common cause of vision loss following uncomplicated
cataract removal either with or without implantation of intraocular
lens
- Other conditions that may be complicated with CME include:
diabetes, intraocular inflammation, vascular
occlusions, epiretinal membrane, macroaneurysm,
exudative age-related macular degeneration, hypotony and retinal detachment
- Clinical features:
- Symptoms:
- Reduced visual acuity
- Hyperopic shift refraction
- Signs:
- Loss of foveal depression
- Thickening of the retina associated with translucent intraretinal
cystoid spaces at the posterior pole
- Fluorescein angiography demonstrates:
- Dye leakage from small points in the midsection of each capillaries
- Pooling of fluorescein in obliquely oriented henle layer which
gives rise a characteristic petaloid staining patter in the perifoveal
region
- Late staining of the optic nerve is associated with inflammatory
CME, typically after cataract extraction
- Optical coherence tomography (OCT) is very helpful for diagnosis
as well as for follow-up of treatment
- Management:
- Rule out infectious process, intraocular derangement such as
entrapment of the iris or vitreous prolapse in the wound, uveitis
or diabetic retinopathy
- Therapeutic approach with topical corticosteroid or cyclo-oxygenase
inhibitor
- Sub-tenon's or intravitreal corticosteroid injection in refractory
cases
- Nd:YAG laser vitreolysis
- Vitrectomy in selected cases
- Intraocular lens removal or replacement
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