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Non diabetic CME
Author(s) -
LOEWENSTEIN A
Publication year - 2012
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2012.4215.x
Subject(s) - medicine , diabetic retinopathy , macular edema , ophthalmology , branch retinal vein occlusion , macular degeneration , aflibercept , etiology , fluorescein angiography , pars plana , diabetes mellitus , vitrectomy , visual acuity , bevacizumab , surgery , pathology , chemotherapy , endocrinology
Purpose Cystoid macular edema (CME) occurs in a variety of pathological conditions beside diabetic retinopathy, such as retinal vein occlusion, pseudophakia, penetrating ocular injury and uveitis. CME is a major cause of vision loss following cataract and vitreoretinal surgery. This presentation overviews the major developments in the treatment of CME, and the contribution of recent clinical trials to the understanding of the pathophysiology and factors that play a role in non‐diabetic CME and outcomes of treatment, as well as the problems that remain to be solved by both the basic and clinical researchers. Methods Differential diagnosis is essential for management and distinction between diabetic, age‐related macular degeneration, and other causes of CME. Pseudophakic CME is characterized by poor visual acuity following surgery. Clinically significant CME generally develops 4‐12 weeks after surgery. The workup of CME is performed with fluorescein angiography and optical coherence tomography. While pseudophakic CME can resolve spontaneously, some cases of CME require treatment.Refined surgical techniques contribute to reducing the incidence of CME. Intraoperative complications may elevate the risk of developing postoperative CME. Results Peri‐ or intraocular corticosteroids can be useful in persistent cases. Topical non‐steroidal anti‐inflammatory drugs (NSAIDs) and corticosteroids show the highest success rate for post‐surgical CME. Conclusion While the etiology of CME remains to be elucidated, the recent years have been the framework of major advances in treatment of CME. The response to antiangiogenic treatment is currently under evaluation, with some reported improvements from bevacizumab monotherapy, and combination therapies with NSAIDs and corticosteroids. Surgical treatment is considered in severe case.Commercial interest