Management of pseudophakic cystoid macular edema

Guo, Suqin; Patel, Shriji; Baumrind, Ben; Johnson, Keegan S.; Levinsohn, Daniel; Marcus, Edward; Tannen, B. L.; Roy, Monique; Bhagat, Neelakshi; Zarbin, Marco A.

doi:10.1016/j.survophthal.2014.08.005

Cited by 87 publications

(109 citation statements)

References 122 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In general, cataract surgery results in intraocular inflammation produced by inflammatory mediators that cause increased expression of vascular endothelial growth factor (VEGF), which potently induces increased permeability of the perifoveal capillary net and breakdown of the BRB (5) . However, to date, no studies have shown increased ocular VEGF levels in patients with PCME in the absence of ischemic ocular disease (2) . The DEX implant has been approved by the US FDA for the treatment of ME secondary to RVO, for non-infectious posterior uveitis and for the treatment of diabetic ME in patients who are pseudophakic or are phakic and scheduled for cataract surgery (4) .…”

Section: Discussionmentioning

confidence: 99%

“…The pathogenesis of PCME remains unclear, but it is generally agreed that inflammation plays a major role in its development (2,4,5,7) . Breakdown of the BAB and BRB may be associated with diabetes and glaucoma (2) .…”

Section: Discussionmentioning

confidence: 99%

“…Breakdown of the BAB and BRB may be associated with diabetes and glaucoma (2) . Patients with diabetes, particularly those with diabetic retinopathy, are at an increased risk of developing PCME (8) .…”

Section: Discussionmentioning

confidence: 99%

“…It was first described in 1953 by Irvine, and in 1966, Gass and Norton published an angiographic study of its characteristics (1,2) . The incidence of clinical (symptomatic) PCME has been greatly reduced because of its advances in surgical techniques (approximately 0.1%-2.35%), and most cases of PCME have spontaneous resolution (2) . Majority of patients remain asymptomatic without active inflammation on fundus examination and optical coherence tomography (OCT) (3) .…”

Section: Introductionmentioning

confidence: 99%

“…Most investigators agree that inflammation is the main etiologic factor in the development of PCME (5) . Inflammatory mediators disrupt the blood-aqueous barrier (BAB) and blood-retinal barrier (BRB), leading to an amplification of retinal permeability and the development of PCME (2,5) . No recent significant studies have been conducted to establish the best therapeutic options for treating this disorder (4) .…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Dexamethasone 0.7 mg implants in the management of pseudophakic cystoid macular edema

Garcia

Isaac

Ávila

2016

Arquivos Brasileiros De Oftalmologia

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Dexamethasone 0.7 mg implants in the management of pseudophakic cystoid macular edema

Garcia

Isaac

Ávila

2016

Arquivos Brasileiros De Oftalmologia

View full text Add to dashboard Cite

Prednisolone and Ketorolac vs Ketorolac Monotherapy or Sub-Tenon Prophylaxis for Macular Thickening in Cataract Surgery

et al. 2021

View full text Add to dashboard Cite

The choice of anti-inflammatory prophylaxis parallel to cataract surgery is important for patient safety and successful outcome of surgery, but which regimen to choose is contested.OBJECTIVES To determine whether a combination of prednisolone and nonsteroidal anti-inflammatory drug (NSAID) eye drops was superior in preventing increased central macular thickness (central subfield thickness [CST]) after uncomplicated cataract surgery compared with NSAID monotherapy and sub-Tenon capsule depot (dropless surgery), and to test whether preoperative initiation of eye drop treatment was superior to initiation on the day of surgery. DESIGN, SETTING, AND PARTICIPANTS This investigator-driven, single-center, randomized clinical trial with masked statistical analyses enrolled patients at the Department of Ophthalmology, Rigshospitalet Glostrup, Glostrup, Denmark, from February 1, 2018, to August 15, 2019. Follow-up was completed December 18, 2019. Participants included low-risk patients undergoing phacoemulsification for age-related cataract by an experienced surgeon (1 eye per participant). Data were analyzed from February 17 to June 15, 2020.INTERVENTIONS Participants scheduled for cataract removal were randomized to 1 of 5 anti-inflammatory prophylactic regimens: eye drops with a combination of prednisolone, 1%, and ketorolac tromethamine, 0.5%, with or without preoperative initiation (preoperative prednisolone plus NSAID [control] and postoperative prednisolone plus NSAID groups), ketorolac monotherapy with or without preoperative initiation (preoperative and postoperative NSAID groups), or sub-Tenon depot of dexamethasone phosphate (sub-Tenon group). Eye drops were administered 3 times per day until 3 weeks postoperatively. MAIN OUTCOMES AND MEASURES CST 3 months postoperatively.RESULTS A total of 470 participants (mean [SD] age, 72.2 [7.0] years; 290 women [61.7%]) with 94 participants in each group were included in the analysis. Three months after surgery, the mean CST was 250.7 (95% CI, 247.6-253.7) μm in the preoperative prednisolone plus NSAID group, 250.7 (95% CI, 247.8-253.7) μm in the postoperative prednisolone plus NSAID group, 251.3 (95% CI, 248.2-254.4) μm in the preoperative NSAID group, 249.2 (95% CI, 246.2-252.3) μm in the postoperative NSAID group, and 255.2 (95% CI, 252.0-258.3) μm in the sub-Tenon group. There were no significant differences in CST or visual acuity compared with control and no differences between preoperative and postoperative groups, but 47 of 83 participants (56.6%) in the sub-Tenon group needed additional anti-inflammatory treatment.CONCLUSIONS AND RELEVANCE No differences in CST or visual acuity were detected between the combination of prednisolone and NSAID eye drops vs NSAID monotherapy or sub-Tenon dexamethasone depot, although more than one-half of patients in the sub-Tenon arm received additional anti-inflammatory treatment. Initiating prophylaxis 3 days preoperatively was not superior to initiation on the day of surgery. Monotherapy with NSAIDs may be preferred in uncomplicate...

show abstract

Pseudophakic Cystoid Macular Oedema

Ugarte

2021

Cataract Surgery

View full text Add to dashboard Cite

Management of pseudophakic cystoid macular edema

Cited by 87 publications

References 122 publications

Dexamethasone 0.7 mg implants in the management of pseudophakic cystoid macular edema

Dexamethasone 0.7 mg implants in the management of pseudophakic cystoid macular edema

Prednisolone and Ketorolac vs Ketorolac Monotherapy or Sub-Tenon Prophylaxis for Macular Thickening in Cataract Surgery

Pseudophakic Cystoid Macular Oedema

Contact Info

Product

Resources

About