Treatment of cystic macular lesions in hereditary retinal dystrophies

Salvatore, Serena; Fishman, Gerald A.; Genead, Mohamed A.

doi:10.1016/j.survophthal.2012.11.006

Cited by 56 publications

(41 citation statements)

References 169 publications

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“…Cystoid macular edema (CME) represents a known complication in patients with some hereditary retinal degenerations such as retinitis pigmentosa, X-linked retinoschisis, enhanced cone syndrome, choroideremia, and gyrate atrophy and is characterized by a localised expansion of the macular intracellular and/or extracellular space [18, 19]. Various pathogenetic mechanisms have been offered to explain the cystic macular lesions in retinal dystrophies including blood-retinal barrier impairment and tangential vitreous traction [19].…”

Section: Discussionmentioning

confidence: 99%

“…Various pathogenetic mechanisms have been offered to explain the cystic macular lesions in retinal dystrophies including blood-retinal barrier impairment and tangential vitreous traction [19]. Spalton et al [20] suggested that macular edema might be due to an inflammatory response seen in many types of tapetoretinal degenerations against actively degenerating photoreceptors and retinal pigment epithelium.…”

Section: Discussionmentioning

confidence: 99%

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Cystoid Macular Edema in Bietti's Crystalline Retinopathy

Saatçi

Doruk

Yaman

2014

Case Reports in Ophthalmological Medicine

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A 27-year-old man with progressive bilateral visual decline was diagnosed to have Bietti's crystalline dystrophy (BCD). Fluorescein angiography revealed bilateral petaloid type late hyperfluorescence implicating concurrent cystoid macular edema (CME). Optical coherence tomography exhibited cystoid foveal lacunas OU. During the follow-up of six years, intraretinal crystals reduced in amount but CME persisted angiographically and tomographically. CME is among the rare macular features of BCD including subfoveal sensorial detachment, subretinal neovascular membrane, and macular hole.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Cystoid Macular Edema in Bietti's Crystalline Retinopathy

Saatçi

Doruk

Yaman

2014

Case Reports in Ophthalmological Medicine

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“…62 and two had fluorescein angiographic improvement. 63 Subsequently, oral acetazolamide has been used in a variety of types of CME including uveitis and postcataract, but it has probably been most used by ophthalmologists in the treatment of CME associated with retinal dystrophies.…”

Section: Topical Carbonic Anhydrase Inhibitorsmentioning

confidence: 93%

Recent Advances in Topical Therapeutics for Vitreoretinal Diseases

Gibson¹,

McGinnigle

2015

US Ophthalmic Review

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Amongst other attributes, the ideal drug for retinal disorders should be easy to administer, safe, have a long duration of action, and be costeffective. Needless to say, to date, no such drug exists as far as we are aware, but how close does topical delivery come to meeting these aspirations? Compared with intravitreal drug delivery, topical delivery has some obvious advantages and disadvantages and these are summarized in Table 1.Maurice wrote a seminal review of this subject in 2002, in which he was particularly interested in the passage of drugs delivered by eye AbstractEye drops are convenient for patients, but achieving therapeutic doses and maintaining sustained drug release without frequent re-application to treat diseases of the retina has been largely unsuccessful. Topical administration of drugs is hindered by the anatomy, physiology, and biochemistry of the eye and its highly effective defence mechanisms. Advances in nanotechnology have led to the experimental use of topical permeation-enhancing liposomes, emulsions, and microspheres to enhance absorption and penetration of drugs across membranes; allow controlled release of the drug; and to target drugs at distinct tissues to allow sufficient local bioavailability. In the near future it is hoped that improved technologies may provide means of sustained topical drug delivery for retinal therapy, with improved side-effect profiles and reduced cost compared with currently available clinical treatments.

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“…Depending on its cause, acute oedema may resolve spontaneously. 33 Cystoid macular oedema is the result of chronic oedema that persists for ≥ 4 months, leading to the formation of cystic honeycomb-like spaces in the retina, 34 and can occur as a consequence of retinal dystrophies, 35 inflammatory diseases (uveitis, scleritis, birdshot chorioretinopathy, toxoplasmosis), 36 retinal vascular disease (retinal vein occlusions, idiopathic retinal telangiectasia, radiation retinopathy), 34 diabetic retinopathy, 34 cataract or other eye surgery, injury to the eye, choroidal tumours, or may be drug induced, for example with prostaglandins such as latanoprost. 37 As with other macular conditions, the main symptoms of cystoid macular oedema are blurred or decreased central vision, but peripheral vision is unaffected.…”

Section: Cystoid Macular Oedemamentioning

confidence: 99%

Accuracy of fundus autofluorescence imaging for the diagnosis and monitoring of retinal conditions: a systematic review

Frampton

Kalita

Payne

et al. 2016

Health Technol Assess

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BackgroundNatural fluorescence in the eye may be increased or decreased by diseases that affect the retina. Imaging methods based on confocal scanning laser ophthalmoscopy (cSLO) can detect this ‘fundus autofluorescence’ (FAF) by illuminating the retina using a specific light ‘excitation wavelength’. FAF imaging could assist the diagnosis or monitoring of retinal conditions. However, the accuracy of the method for diagnosis or monitoring is unclear.ObjectiveTo conduct a systematic review to determine the accuracy of FAF imaging using cSLO for the diagnosis or monitoring of retinal conditions, including monitoring of response to therapy.Data sourcesElectronic bibliographic databases; scrutiny of reference lists of included studies and relevant systematic reviews; and searches of internet pages of relevant organisations, meetings and trial registries. Databases included MEDLINE, EMBASE, The Cochrane Library, Web of Science and the Medion database of diagnostic accuracy studies. Searches covered 1990 to November 2014 and were limited to the English language.Review methodsReferences were screened for relevance using prespecified inclusion criteria to capture a broad range of retinal conditions. Two reviewers assessed titles and abstracts independently. Full-text versions of relevant records were retrieved and screened by one reviewer and checked by a second. Data were extracted and critically appraised using the Quality Assessment of Diagnostic Accuracy Studies criteria (QUADAS) for assessing risk of bias in test accuracy studies by one reviewer and checked by a second. At all stages any reviewer disagreement was resolved through discussion or arbitration by a third reviewer.ResultsEight primary research studies have investigated the diagnostic accuracy of FAF imaging in retinal conditions: choroidal neovascularisation (one study), reticular pseudodrusen (three studies), cystoid macular oedema (two studies) and diabetic macular oedema (two studies). Sensitivity of FAF imaging using an excitation wavelength of 488 nm was generally high (range 81–100%), but was lower (55% and 32%) in two studies using longer excitation wavelengths (514 nm and 790 nm, respectively). Specificity ranged from 34% to 100%. However, owing to limitations of the data, none of the studies provide conclusive evidence of the diagnostic accuracy of FAF imaging.LimitationsNo studies on the accuracy of FAF imaging for monitoring the progression of retinal conditions or response to therapy were identified. Owing to study heterogeneity, pooling of diagnostic outcomes in meta-analysis was not conducted. All included studies had high risk of bias. In most studies the patient spectrum was not reflective of those who would present in clinical practice and no studies adequately reported how FAF images were interpreted.ConclusionsAlthough already in use in clinical practice, it is unclear whether or not FAF imaging is accurate, and whether or not it is applied and interpreted consistently for the diagnosis and/or monitoring of retinal conditions. Well-designed prospective primary research studies, which conform to the paradigm of diagnostic test accuracy assessment, are required to investigate the accuracy of FAF imaging in diagnosis and monitoring of inherited retinal dystrophies, early age-related macular degeneration, geographic atrophy and central serous chorioretinopathy.Study registrationThis study is registered as PROSPERO CRD42014014997.FundingThe National Institute for Health Research Health Technology Assessment programme.

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Treatment of cystic macular lesions in hereditary retinal dystrophies

Cited by 56 publications

References 169 publications

Cystoid Macular Edema in Bietti's Crystalline Retinopathy

Cystoid Macular Edema in Bietti's Crystalline Retinopathy

Recent Advances in Topical Therapeutics for Vitreoretinal Diseases

Accuracy of fundus autofluorescence imaging for the diagnosis and monitoring of retinal conditions: a systematic review

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