Vitreous & Retina

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Macular Diseases
Cystoid macular edema in a case of chronic macular pucker.

  • 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

Copyright © 2003 Digital Reference of Ophthalmology. All rights reserved. All material published on this website is the property of Digital Reference of Ophthalmology and cannot be duplicated without permission.
Home Search Home Search