Premium
Controversies in the use of NSAIDs
Author(s) -
Pleyer U.
Publication year - 2016
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.1755-3768.2016.0107
Subject(s) - medicine , nonsteroidal , intensive care medicine , cataract surgery , macular edema , first line , surgery , pharmacology , visual acuity
Summary Pseudophakic cystoid macular edema (PCME) remains the most common cause of poor visual outcome following cataract surgery. Whereas acute PCME may resolve spontaneously, some patients will suffer from vision impairment and are difficult to treat. Even though PCME has been already described 50 years ago, its pathophysiology remains uncertain and a multitude of mechanisms have been suggested. As broad as the mechanisms, are the options to treat this condition. Topical nonsteroidal anti‐inflammatory agents (NSAIDs) and corticosteroids either as mono‐ or combined therapy are commonly used as first line approach. When ineffective, systemic treatment with these agents might be an option. Alternatively, intravitreal application of corticosteroids and anti‐vascular endothelial growth factor (anti‐VEGF) may offer an effective choice, when first line treatment failed. A critical evaluation of the current knowledge reveals that the optimal treatment of PCME remains unclear and needs further investigation. In addition, prevention should be of foremost importance and is also an open issue. Identification of risk factors, application of NSAIDs and consequent follow up are probably essential steps to avoid this complication.