1/5/2018 Cystoid Macular Edema - EyeWiki(/Main_Page) Log in (/w/index.php?title=Special%3AUserLogin&returnto=Cystoid+Macular+Edema) Search Page (/Cystoid_Macular_Edema) Discussion (/w/index.php?title=Talk%3ACystoid_Macular_Edema&action=edit&redlink=1) View form (/w/index.php?title=Cystoid_Macular_Edema&action=formedit) Edit source (/w/index.php?title=Cystoid_Macular_Edema&action=edit) History (/w/index.php?title=Cystoid_Macular_Edema&action=history) Cystoid Macular Edema Original article contributed by Pooja G. Garg, MD (/User%3APooja.G.Garg) (/Property%3AAuthors): Brad H. Feldman, M.D. (/User%3ABrad.H.Feldman.DEC), Pooja G. Garg, MD (/User%3APooja.G.Garg) and Vinay A. All contributors: Shah M.D. (/User%3AVinay.A.Shah.SEC) Assigned editor: Marc Spirn, MD (/User%3AMarc.Spirn) Review: Assigned status Update Pending by Vinay A. Shah M.D. (/User%3AVinay.A.Shah.SEC) on December 21, 2014. Cystoid Macular Edema Classi cation and external resources ICD H (http://en.wikipedia.org/wiki/ICD- (http://en.wikipedia.org/wiki/International_Statistical_Classi cation_of_Diseases_and_Related_Health_Problems)-10 10_Chapter_VII:_Diseases_of_the_eye,_adnexa)59.039 (http://en.wikipedia.org/wiki/ICD-10) (http://apps.who.int/classi cations/icd10/browse/2010/en#/H59.039) ICD (http://en.wikipedia.org/wiki/International_Statistical_Classi cation_of_Diseases_and_Related_Health_Problems)-9 362.53 (http://www.icd9data.com/getICD9Code.ashx?icd9=362.53) (http://en.wikipedia.org/wiki/List_of_ICD-9_codes) OMIM (http://en.wikipedia.org/wiki/OMIM) 153880 (http://omim.org/entry/153880) DiseasesDB (http://en.wikipedia.org/wiki/Diseases_Database) 33938 (http://www.diseasesdatabase.com/ddb33938.htm) Contents 1 Disease Entity 1.1 Disease 1.2 Pathophysiology 2 Diagnosis 2.1 Signs 2.2 Symptoms 2.3 Risk Factors 2.4 Imaging 3 Management 3.1 General treatment 3.2 Medical therapy [22] 3.3 Surgery 4 Prognosis 5 Additional Resources 6 References Disease Entity International Classi cation of Disease (ICD) 2014 ICD-9-CM 362.53 Cystoid Macular Degeneration Disease The American Academy of Ophthalmology Preferred Practice Patterns de nes Cystoid Macular Edema (CME) as retinal thickening of the macula due to a disruption of the normal blood-retinal barrier; this causes leakage from the perifoveal retinal capillaries and accumulation of uid within the intracellular spaces of the retina, primarily in the outer plexiform layer [1]. Visual loss occurs from retinal thickening and uid collection that distorts the architecture of the photoreceptors. CME is a leading cause of central vision loss in the developed world [2]. Pathophysiology A delicate exchange of homeostatic mechanisms is in place with the vitreous, retina, retinal pigment epithelium (RPE), and choroid receiving their circulation through the retinal and choroidal vasculature. http://eyewiki.aao.org/Cystoid_Macular_Edema 1/6 metamorphopsia that can be demonstrated on Amsler grid. this is better visualized using green light to outline the cystic spaces. hydrostatic force. Accumulation of the uid commonly occurs in the Henle’s ber layer causing the classic petaloid pattern. The OPL is more prone to uid collection due to the watershed area that exists between the retinal and choroidal circulation. This results in blood-retinal barrier breakdown from separation of the retina and RPE. [17] One study indicated that 28% of aphakic eyes treated with epinephrine drops vs 13% of untreated aphakic eyes developed CME [18]. such as glial and RPE cells.org/Cystoid_Macular_Edema 2/6 . Resolution of Epinephrine CME occurred with cessation of epinephrine drops. Hard exudates within 500 μm of the foveal center that are associated with adjacent retinal thickening (which may lie more than 500 μm from the foveal center). VMT can cause stress at the Muller cell end-feet.aao. Speci cally. Leakage on uorescein angiography does not seem to correlate with a decrease in visual acuity [11]. Once these forces are disrupted an imbalance occurs and accumulation of uid is seen in cystoid spaces within the inner layers of the retina. interleukin-10. most commonly the outer plexiform layer (OPL). Diabetic macular edema (DME) is associated with leakage from microaneurysms and retinal capillaries causing circinate rings of hard exudates or lipoprotein deposits. and tumor necrosis factor- [19]. and Niacin Various types of surgery can induce in ammation and alter the retinal blood ow. any part of which is located within 1 disc area of the foveal center. lysis of muller cells. Early Treatment Diabetic Retinopathy Study (ETDRS) de nes clinically signi cant macular edema as: Diabetes Any retinal thickening within 500 μm of the foveal center. a common factor that can cause CME is vitreomacular traction (VMT). prostaglandin Nicotinic acid Blurry vision associated with CME has been reported in doses greater than 1. 95% of CME due to Irvine-Gass has been shown to resolve spontaneously within 6 months [20] [21][22][23]. Surgery Pars plana vitrectomy (PPV) Laser photocoagulation Cryopexy Glaucoma procedures Risk factors that do not demonstrate leakage on FA include: Juvenile retinoschisis Goldmann-Favre disease Certain types of RP Nicotinic Acid maculopathy Phototoxicity Antimicrotubule agents http://eyewiki. and tissue compliance that occur within the vasculature [3][4]. and platelet-derived growth factor (PDGF). capillary permeability. Risk Factors DEPRIVENS is a common mnemonic for risk factors that cause leakage on FA [12][13][14][15][16]. and central scotoma. Treatment of CME prior to undergoing any procedures listed below can prevent the acceleration or persistence of pre-existing edema [25]. Diagnosis Signs Using slit lamp or direct/indirect ophthalmoscopy. leakage and edema [6][7][8][9]. exerting tractional forces and contributing to the release of in ammatory factors such as basic broblastic grown factor (bFGF).5g/day [24]. Pars In pars planitis. interleukin-2. An area of retinal thickening at least 1 disc area in size. Irvine-Gass CME usually occurs up to 6-10 weeks postoperatively. 1% of these have a clinically signi cant decrease in visual acuity. Vein Occlusion E2- E2-prostaglandins cause disruption of the tight junctions of the retinal capillaries. this gure can reach 20%. Planitis/Uveitis α that has been associated with CME Retinitis Pigmentosa (RP) Irvine-Gass is an in ammatory process occurring in up to 20% of cataract extraction with intraocular lens. especially within the central retina due to its anatomical avascular zone [5]. such as those in which there is violation of the posterior capsule. Speci cally. loss of contrast sensitivity and color vision. micropsia.EyeWiki A variety of risk factors may disrupt the normal interactions affecting the retinal environment. Vitritis and optic nerve head swelling can also be seen in clinical examination. in more complicated surgeries.1/5/2018 Cystoid Macular Edema . Subclinical foveal edema is described as edema less than 300 μm and is better seen through retinal imaging [10]. there is accumulation of T-cell in ammatory mediators such as interferon-Y. Symptoms Symptoms include decrease in visual acuity that is associated with retinal edema. vascular endothelial growth factor (VEGF). the capillary ltration rate should equal the rate of uid removal from extracellular retinal tissue. clinically signi cant foveal edema and retinal thickening more than 300 μm can be seen as a loss of foveal re ex. There is an intrinsic balance amongst the osmotic force. jpg) OCT can depict the mechanical forces induced by vitreomacular interface abnormalities.jpg) Less common but pathognomonic for CME is a smokestack pattern.1/5/2018 Cystoid Macular Edema .EyeWiki Imaging Color Fundus Photography (CFP) depicts intraretinal cysts within the foveal region of the macula in Henle's layer (Figure 1). leakage into the cystoid spaces is distributed radially in Henle’s layer forming the classic petaloid leakage pattern or expansile dot appearance (Figure 3). the appearance looks more honeycomb-like [10][26][27]. OCT can be diagnostic through measurement of the retinal thickening with depiction of the intraretinal cystic areas of low re ectivity in OPL [28][29] (Figure 4). Management http://eyewiki. FA can also show late staining of the optic disc. Scanning laser ophthalmoscope (SLO) scans a small focused spot of the retina.jpg) Fluorescein Angiography (FA) studies the circulation of the retina and choroid. such as VMT or epiretinal membrane (ERM).jpg) In the late phase of FA. high-resolution images of the retina. In the early phase of FA. (/File%3AEarly_FA_Left_eye_CME. In CME. via a hyperre ective band on the inner surface of the retina [30][31]. capillary dilation in the perifoveal region is appreciated (Figure 2). Auto uorescence (AF) depicts the health of the RPE and intraretinal cysts appear as hyperauto uorescent. Retinal Thickness Analyzer (RTA) generates a wide 3D map of the retina. (/File%3AFA_ nal_1.org/Cystoid_Macular_Edema 3/6 . such as in the peripheral retina or near the optic nerve. (/File%3AOCT_Left_Eye_CME. (/File%3ALate_FA_Left_Eye_CME. If leakage is elsewhere. Optical Coherence Tomography (OCT) objectively obtains cross-sectional.aao. especially when refractory to medical therapy. If CME persists then medical or surgical therapy is warranted. ranibizumab (antibody fragment). Scholl S. Follow-up study of cystoid macular edema following cataract extraction. multicenter study of patients with chronic aphakic CME. One hypothesis to explain the effect of laser is that adjacent healthy RPE cells replace necrotic cells and reform a tight junctional retinal barrier [42].21:10-19. and RP has shown anatomical improvement. Konstantinidis et al.5%. 1988. Niacin maculopathy. American Diabetes Association: Economic costs of diabetes in the US in 2002.1/5/2018 Cystoid Macular Edema . General pathophysiology of macular edema. Ophthalmologica. 2. studies have shown that oxygen in the posterior segment and the rate of oxygen exchange in the vitreal cavity is increased after PPV [78][79][80][81][82][83]. Reichenbach A. and a rise in intraocular pressure. 2017 . Steroids speci cally help in uveitic macular edema. Also. dispase. Gass JD. Scholl S. Speci cally. Laser photocoagulation – Laser photocoagulation uses a light source to coagulate retinal and RPE tissue. Surgery PPV can help to relieve macula edema through tractional or nontractional components. References 1. Though internal limiting membrane peeling in CME secondary to diabetes. whether medical or surgical.aao. Depending on the etiology. Loewenstein A. indomethacin 1%. vitreous hemorrhage. CAIs are helpful in paclitaxel and docetaxel induced CME [39][40] and RP induced CME [41]. Augustin AJ. one study has shown that high vitreous levels of VEGF in CRVO patients correlated with less improvement in visual acuity after vitrectomy. showed statistically signi cant improvement in visual outcomes following vitrectomy [58]. Bringmann A. visual acuity results are inconclusive [62][63][64][65][66][67][68][69][70][71][72][73]. 2010. Kirchhof J. Tractional components can be addressed by releasing the posterior hyaloid in VMT or conducting an internal limiting membrane peel of an ERM. intravitreal triamcinolone is used to visualize the posterior hyaloid to assist in surgical removal of traction. In particular. and an injectible version of the uocinolone acetonide implant. Jampol LM. demonstrated that vitrectomy done on vitreous incarceration in the anterior segment and pseudophakic macular edema resulted in improvement in visual acuity in all patients [61]. Wiedemann P. Diabetes Care. et al. Furthermore. Carbonic anhydrase inhibitors (CAIs) – CAIs alter the polarity of the ionic transport systems in the RPE moving uid away from the intracellular spaces [38]. Additional Resources American Academy of Ophthalmology. intravitreal triamcinolone reduces uid accumulation by stimulating endogenous adenosine signaling in Muller cells and decreasing VEGF production [34][35]. Speci cally. demonstrated that vitrectomy in pseudophakic CME without any tractional component showed an improvement in visual acuity [90]. Side effects of vitrectomy include cataract. and diclofenac 1% are used postoperatively for aphakic or pseudophakic CME (/Pseudophakic_Cystoid_Macular_Edema_(Irvine-Gass_Syndrome)) [32] [33].2019 (http://store. Ophthalmology. Anti-VEGF agents – Pegaptanib (anti-VEGF 165 RNA aptamer). plasmin. Dall T.aao. Pathophysiology of macular edema. 4. 1969.org/practicing-ophthalmologists-learning-system-2017-2019. one study showed an increase in VEGF levels in branch retinal vein occlusion (BRVO) patients correlated with an improvement in visual acuity after vitrectomy [77]. PPV for nontractional components causing CME secondary to diabetes and uveitic macular edema has resulted in inconclusive data on improvement in visual acuity [84][85][86][87][88][89]. 2017. There are currently four corticosteroid-based intravitreal implants: dexamethasone biodegradable implant. retinal detachment. Pharmacologic vitreolysis agents – Chondroitinase.73:665-682. Pathomechanisms of cystoid macular edema. intravitreal injection or implant corticosteroids inhibit phospholipase A2 that consequently inhibits prostaglandin and leukotriene production. uveitic macular edema. Ophthalmic Res.26:917-932. uocinolone acetonide implant. An alternative hypothesis depicts a reduction of oxygen consumption in the outer retina allowing diffusion of oxygen to the inner retina relieving hypoxia causing constriction of retinal vasculature and a decrease in uid accumulation [43]. systemic. Marked reduction in retinal thickness and uid accumulation has been noted in various studies with a signi cant improvement in visual acuity with minimal side effects [44][45][46][47][48]. central retinal vein occlusion (CRVO). Well-known side effects of steroid injection include glaucoma and cataract formation [37]. suggesting that high VEGF levels may be associated with ischemia and permanent photoreceptor damage [76]. A side effect of laser photocoagulation is scotoma that usually resolves in several weeks. Corticosteroids – Topical. 3. PPV for the tractional component of VMT causing CME secondary to diabetes has been shown to improve macular edema in 80-92% of patients [59][60]. periocular. Most cases are self-limiting within 3-4 months. Nikolov P.org/Cystoid_Macular_Edema 4/6 .html) San Francisco: American Academy of Ophthalmology. and ease of storage and administration. 2010. resolution of the edema may be helped via medical or surgical options.36:241-249. Ketorolac tromethamine 0. 2003. Eur J Ophthalmol. and bevacizumab (full antibody) act by decreasing vascular permeability from disrupted endothelial cells. 2004. Nontractional components are addressed by theoretically clearing the in ammatory factors when undergoing PPV [74][75]. Medical therapy [22] NSAIDS – Topical or systemic indomethacin inhibits cyclooxygenase enzyme that decreases the production of prostaglandins. Phase III trial has shown that intravitreal injection of 125 μg for treatment of VMT associated with subjective visual dysfunction showed improvement of the adhesion [57]. and microplasmin induce a posterior vitreous detachment to relieve VMT [49][50][51] [52]. However. The Vitrectomy-Aphakic-Cystoid Macular Edema Study. hyaluronidase. a prospective. such as vitreous adhesions to iris. Phase II trial has shown that a 125 μg dose repeated three times released VMT in 58% of patients one month after injection [53][54][55]. If the edema is chronic (more than 6-9 months) permanent damage to the photoreceptors with retinal thinning and brosis can occur [91][92][93][94]. Norton EW. Harbour et al. Microplasmin is currently the agent that shows greatest promise with its stability. patient tolerance. helical triamcinolone acetonide implant. 5. demonstrated that intravitreal triamcinolone with PPV improved anatomic and visual outcome [36]. Pendergast et al.95:1704-1705. Hogan P. However. Retina/Vitreous: Cystoid macular edema Practicing Ophthalmologists Learning System. 6.EyeWiki General treatment Therapeutic approaches. Phase IIb trial has shown that intravitreal injection of 125 μg seven days prior to vitrectomy resolved VMT in 28% of patients [56]. Augustin A. in treating CME are dependent on the underlying etiology. Neodymium yttrium aluminum garnet (Nd:YAG) laser can also help to relieve tractional components.224:8-15.Trans Am Acad Ophthalmol Otolaryngol. Prognosis CME is usually self-limiting and spontaneously resolves within 3-4 months. http://eyewiki. Intravitreal bevacizumab (Avastin) treatment of macular edema in central retinal vein occlusion: a short-term study. Spalton DJ. Smith SD.21:172-177. Intravitreal plasmin without vitrectomy for macular edema secondary to branch retinal vein occlusion. 18. Pulia to CA. Double-masked trial of fenoprofen sodium: treatment of chronic aphakic cystoid macular edema.13:187-191. Invest Ophthalmol Vis Sci. 2012. Jampol LM. et al. Hay E. Am J Ophthalmol.129:283-287.34:152-161. Ophthalmology. 2007.94:1134-1139. Correlation of epinephrine use and macular edema in aphakic glaucomatous eyes. Letko E. Arch Ophthalmol. In: Ryan SJ. Sakuma T. 23. 2005. et al. 2010. Meniconi M. Iturralde D. et al. et al. Goldstein M. Cystoid macular edema. http://eyewiki. Effect of laser photocoagulation on oxygenation of the retina in miniature pigs. et al. 49. Adverse ocular effects associated with niacin therapy. Tessler H. Pharmacologic vitreolysis. Improvement in visual acuity in chronic aphakic and pseudophakic cystoid macular edema after treatment with topical 0. Molnar I. Williamson TH.16:95-97. de Smet MD. Review. 25. Hollenhurst RW. Wilkinson CP.4:1–5. Lai D.112:514-519. ed. Blair NP. 39. Thomas JV. Paclitaxel retinopathy. Ophthalmic Surg. Mavrofrides EC.8:426–427. 50. Optical coherence tomographic patterns of diabetic macular edema. Moschos MN. Papakonstantinou E. 26. Semin Ophthalmol.107:1445–1452. 13. 2002. Isenberg S. Treatment of chronic macular edema with acetazolamide. Wurm A. 20. et al. Pseudophakic cystoid macular edema.7(3):235-239. 47. Whitcup SM. 1995. Brown GC. Kampik A.106:663–668. Tsacopoulos M. Bradford JD. Nussenblatt RB. 2009. Kaufman SC. Bradford RH.47:27-48. Intraocular bevacizumab for macular edema due to CRVO. Augustin A. 1983. 2006. Fiscella RG. 42. Mayo Clin Proc. Gilbert LD. 2010. Falavarjani KG. Konstantinidis L.Am J Ophthalmol. Pannicke T. Klangas I. et al. The natural history of macular edema after cataract surgery in diabetes. Informa Healthcare. Optical coherence tomography and cataract surgery. 15. Udaondo P. Optical coherence tomography in diabetic macular edema. 1988. Arch Ophthalmol. 1978. et al. 29. Cox SN. Graefes Arch Clin Exp Ophthalmol. Early Treatment Diabetic Retinopathy Study Research Group. New York. Sakuma T. Arch Ophthalmol. Lloyd A. Retina. Eye (Lond). Burnett J. Macular thickening and visual acuity. 2008. Reichenbach A.47:10-26. Wright PL. OCT in the management of diabetic macular edema. 2007. et al. Spaide RF. 1985. Curr Opin Ophthalmol. Isr Med Assoc J. Rheaume MA. et al. Group M-TS. A placebo-controlled trial of microplasmin intravitreous injection to facilitate posterior vitreous detachment before vitrectomy. 31. Telender DG.26:279–284. Joshi MM. Arch Ophthalmol. peeling. Hykin PG.117:791-797. Macular edema. 1991. Delaey C. Mizota A. Meyerle CB. Cystoid macular edema with Docetaxel chemotherapy and the uid retention syndrome. Cystoid macular edema. Garcia-Delpech S. Semin Ophthalmol. Waheed NK. Retina. Zajadacz J. Magargal LE. Gonzalez V. 32. 2004.79:54-56. Anatomic and functional outcome after 23-gauge vitrectomy. Semin Ophthalmol. 30. 1992.30:1122-1127. 1985. 56. Berguiga M. 2009. Wilkinson CP. Diaz-Llopis M. Invest Ophthalmol Vis Sci. Liu Q. Sarraf D. Vitreous and serum levels of platelet-derived growth factor and their correlation in patients with proliferative diabetic retinopathy. Ophthalmology.125:709-710. Early Treatment Diabetic Retinopathy Study report no 1. 43.51:1683-1690. Angiographic cystoid macular edema after posterior chamber lens implantation.13:205– 212. Loewenstein A. Curr Ophthalmol Rep. Staurenghi G. Gragoudas ES. Modarres M. et al. Kearns TP. Lindqvist N. Balyeat HD. Moschos MM. Intravitreal bevacizumab for pseudophakic cystoid macular edema: a systematic review. 2010. Baskin DE. et al. Retina. et al.142:405-412. Invest Ophthalmol Vis Sci (suppl.247:1019-1023. 22. Thorofare. 2009. Wake eld D. Photocoagulation for diabetic macular edema. 19. 51. Praidou A. Flach AJ. Invernizzi A.25:295-302. Sharma S. and intravitreal triamcinolone for idiopathic macular epiretinal membrane. Pulia to CA. Dev Ophthalmol. 27. Tanaka M. Inoue J. 2009. 1987. Atlas of fundus uorescein angiography. 44. Cruz-Villegas V. 2010. Rotsos TG. Shelsta HN. 2010. Bird AC. 2006. Illingworth DR. Cystoid macular edema after phacoemulsi cation: relationship to blood-aqueous barrier damage and visual acuity. 33. 1989. Kaiser PK. Doc Ophthalmol. 10. 35. A single injection of microplasmic for the treatment of symptomatic vitreomacular adhesion (sVMA): results of the Phase III MIVI-TRUST Program [abstract]. Sturrock GD. II. Ophthalmology. 38. Intravitreal injection of microplasmin for treatment of vitreomacular adhesion: results of a prospective. 2013. J Ophthalmic Vis Res. Beknazar E.130–4. Br J Ophthalmol. et al. In: Schuman JS. Use of autologous plasmin during vitrectomy for diabetic maculopathy. Pharmacologic therapy of pseudophakic cystoid macular edema: 2010 update. 2006.52:6628. Intravitreal triamcinolone acetonide inhibits breakdown of the blood-retinal barrier through differential regulation of VEGF-A and its receptors in early diabetic rat retinas. Grewal J. 2007. Ocular ischemic syndrome. 1988. 41. 52. 1989. Fishman GA. 55.116:1349-1355. NJ: SLACK. Intravitreal triamcinolone acetonide for diabetic macula edema. MO: Mosby. et al. 4th ed. Eur J Ophthalmol.org/Cystoid_Macular_Edema 5/6 . Review. Garretson B.96:625-628. Diagnosis and detection. 1963. Kim BY. Retina. Plasmin-assisted vitrectomy eliminates cortical vitreous remnants.EyeWiki 7. St Louis. 21. Shetty N. 48. D’Amico DJ. et al. et al. The role of cytokines in the pathogenesis of in ammatory eye disease. 46. et al. et al. Androudi S. 9. Dugel PU. Macular edema. Ocul Immunol In amm. Inoue J. Ray S.150:876-882. Ulbig M.13:187-191. Inc. Gandorfer A. Stalmans P. 36. Ophthalmology. J Cataract Refract Surg. Graefes Arch Clin Exp Ophthalmol. 2011. et al. 2002. Kim SJ.57:1026-1033. 1999. Miscellaneous retinal diseases.aao. 24.31(1):4-12. Diabetes. 1988. Kuppermann BD. 40. Loewenstein A. 1999.). Gandorfer A. Curr Eye Res. Poitry S. Brown GC. 2011.29:1119-1127.106:740-744. et al. Acetazolamide for treatment of chronic macular edema in retinitis pigmentosa. Weinberg D. Mortality and systemic morbidity.2(4):919-930. 14. Retina.17:167-180. 2004:457-482.14:150–152. 8. et al. Int Ophthalmol. 34. sham- controlled phase II trial (the MIVI-IIT trial). The ocular ischemic syndrome.22:151-153.8:161–164. randomized. 2010. Optical coherence tomography of ocular diseases. 45. Sehmi KS. Fraunfelder FW. Measurement in patients with cystoid macular edema.20(1):46-51. 2011. Sivalingam A. Dowler JG. et al. Muller cells as players in retinal degeneration and edema. Zhang X. 1990. 2008.38:304-312. et al. 53. Arch Ophthalmol. et al. Am J Ophthalmol. de Polo L. Clin Ophthalmol. 2010. 37. et al. Mueller HR.16:138-140. Chronic ocular ischaemia. 16. de Smet MD. Bressler NM. Gupta B. Curr Opin Ophthalmol. 57. eds. Packo KH.103:1796–1806. Benz MS.245:627-636. Safety and ef cacy of intravitreal triamcinolone acetonide for uveitic macular edema. 2006. 12.2005:1483-1502. Duker JS. A multlifocal-ERG and OCT study. 28. Arch Ophthalmol. 17. et al.5% ketorolac tromethamine. a pilot study. Br J Ophthalmol. Fujimoto JG. 2009. Parvaresh MM.25:1492-1497. Bao S. Palestine AG.106:1190-1195. General pathophysiology. Cystoid macular edema following extracapsular cataract extraction and posterior chamber intraocular lens implantation. 2010. Arch Ophthalmol. Ursell PG.26:1410– 1414. 11. Vavvas D. Retina. Dev Ophthalmol. Microplasmin intravitreal administration in patients with vitreomacular traction scheduled for vitrectomy: the MIVI I trial. Retinal glial (Muller) cells: sensing and responding to tissue stretch. Fraunfelder FT.116:147–152.1:128-133. Cytokine. Stalmans P. 54. 2008. Venous-stasis retinopathy of occlusive disease of the carotid artery.1/5/2018 Cystoid Macular Edema . Moschos MM. Jampol LM. Intravitreal injection of autologous plasmin enzyme for macular edema associated with branch retinal vein occlusion. Measurement of PO2 during vitrectomy for central retinal vein occlusion. Ophthalmology.org/) (https://www. Am J Ophthalmol. Rao NA. 2011. Abrams GW. Blumenkranz MS. Ophthalmology. 2007. Pendergast SD. Haymond RS. Gut eisch M. Results of a national. Categories (/Special%3ACategories): Articles (/Category%3AArticles) Articles articles that need work (/Category%3AArticles_articles_that_need_work) Retina/Vitreous (/Category%3ARetina/Vitreous) Retina/Vitreous articles that need work (/Category%3ARetina/Vitreous_articles_that_need_work) This page was last modi ed on December 1. 2003.26:3-8. 78. 76. et al.97:297–309.103:669–671. et al. Measurement of PO2 during vitrectomy for central retinal vein occlusion.org/Cystoid_Macular_Edema 6/6 . Ophthalmology. Gupta B. 2007. Vitrectomy for diabetic macular traction and edema associated with posterior hyaloidal traction. Int Ophthalmol. Stefansson E. Am J Ophthalmol. Beebe DC. et al. Kumar A.249:997-1008. Pars plana vitrectomy with and without peeling of the inner limiting membrane for diabetic macular edema. Giblin FJ. 86.51:5731-5738. et al. The pathogenesis and clinical presentation of macular edema in in ammatory diseases. Stinnett S. Exp Eye Res. 2010. Azad R. Vitrectomy outcomes in eyes with diabetic macular edema and vitreomacular traction. et al. Garcia-Arumi J. Rubsamen PE. Holekamp NM. 90. Yamamoto S. Vitrectomy for chronic aphakic cystoid macular edema. 2010. Graefes Arch Clin Exp Ophthalmol. Aspiotis M. Leverenz VR. Erginay A.91:345-348. Rao NA. Sinha S. 91. Shui YB. 72. Shui YB. 2009. Ophthalmologica. Retina. Spital G. et al. Visual acuity comparison of vitrectomy with and without internal limiting membrane removal in the treatment of diabetic macular edema. Comparative evaluation of vitrectomy and dye-enhanced ILM peel with grid laser in diffuse diabetic macular edema. Vitrectomy prevents retinal hypoxia in branch retinal vein occlusion. Graefes Arch Clin Exp Ophthalmol. Tezel TH. 59. Ogata K. Gass’ Atlas of Macular Diseases. Noma H. This page has been accessed 124. Changes in foveal thickness after vitrectomy for macular edema with branch retinal vein occlusion and intravitreal vascular endothelial growth factor. Williams GA. 69. Eur J Ophthalmol. Stavrou P. Oxygen distribution in the human eye: relevance to the etiology of open-angle glaucoma after vitrectomy. 71. Muecke M. 92. 2001. Acta Ophthalmol. Am J Ophthalmol. 73. 2007. et al. Tanabe T.135:169-177. Hatchell DL. Eliott D. prospective. Quiram PA. Martinez V. Henderly DE. Vitrectomy results for diffuse diabetic macular edema with and without inner limiting membrane removal.247:1019-1023. et al. 5th ed. Lewis H. et al.88:286-292. Vitrectomy for persistent diffuse diabetic macular edema. 2003. Milman T. 77.108:1140-1144. Kita M.139:302-310. Mimura T. at 12:16. Siegfried CJ.47:73-110. Hassan TS. et al. Baker RM. 68. 64. Am J Ophthalmol. et al. 2011. 2009. Pendergast SD. Williamson TH. Am J Ophthalmol. Funatsu H. Stefaniotou M. 70. 2010. Chikaraishi Y. Apte RS. 61. internal limiting membrane peeling. et al. Guex-Crosier Y. Genstler AJ. Surgical intervention in refractory CME – role of posterior hyaloid separation and internal limiting membrane peeling.31:284-289. Microplasmin-induced posterior vitreous detachment affects vitreous oxygen levels. Massin P. 84.semantic-mediawiki. DeCroos FC.128:317-323.14:137-143. 2004. Mimura T.89:122-125. et al. 2017. Pars planitis. Enzyme-induced posterior vitreous detachment in the rat produces increased lens nuclear pO2 levels. Novack RL.248:1559-1565.115:1916-1922.100:33-43. 63. et al. 2005. Ophthalmologica.226:64-70. Am J Ophthalmol. Br J Ophthalmol. Fung WE. Duguid G. Ertan A. 2008. 87.2012:500-508. Noma H. and panretinal endophotocoagulation for macular edema secondary to central retinal vein occlusion. Patel JI. Haller JA. A prospective randomized trial. 93. Mertoglu O. Kaplan HJ. 1986. Ocul Immunol In amm. 67. 82. 1985. (//www. Ocul Immunol In amm. et al.9:141-151. Am J Ophthalmol. 66. et al. Margherio RR. Matsunaga N. Ophthalmology. et al. Lanzetta P. Kiryu J. 89. Doc Ophthalmol. Hykin PG. 81. Kalogeropoulos C. Pars plana vitrectomy for diabetic macular edema. Dev Ophthalmol. Diabetic macular edema. 1999. 74. Funatsu H.29:161-167. Waltham. Yamasaki M. Macular abnormalities in patients with retinitis pigmentosa: prevalence on OCT examination and outcomes of vitreoretinal surgery. et al. Pars plana vitrectomy with intravitreal triamcinolone: effect on uveitic cystoid macular oedema and treatment limitations.org/wiki/Semantic_MediaWiki) http://eyewiki. Bahadir M.147:627-633. et al. Shuler Jr RK. Letko E. 2000. 60. Role of soluble vascular endothelial growth factor receptor-1 in the vitreous in proliferative diabetic retinopathy. Internal limiting membrane delamination vs posterior hyaloid removal. Qin H. Graefes Arch Clin Exp Ophthalmol. Urbat C. Quiram PA. Gruber D. 85. 2001. 65. Baltatzis S. 2003. 2005. et al. et al. Ophthalmology.110:1164- 1169. Battaglia Parodi M.224:367-373. Henderly DE. 1992.105:227–232. 2011. Bandello F.aao. Grewal J. 2009.341 times. Graefes Arch Clin Exp Ophthalmol. Retina.245:360-368.EyeWiki 58. Pigment epithelium-derived factor and vascular endothelial growth factor in branch retinal vein occlusion with macular edema. Pars plana vitrectomy for cystoid macular edema secondary to sarcoid uveitis. Invest Ophthalmol Vis Sci. Visual acuity and foveal thickness after vitrectomy for macular edema. Vitrectomy for chronic pseudophakic cystoid macular edema. a pilot study. Hagiwara A. Binder S. 62. 2010. et al. et al.mediawiki. et al. Leverenz VR. 1995.99:753-759. Am J Ophthalmol. Noma H. Ophthalmology. randomized investigation. The signi cance of the pars plana exudates in pars planitis. Invest Ophthalmol Vis Sci. et al.1/5/2018 Cystoid Macular Edema .117:1087-1093. Stolba U. Reichelt JA. Pars plana vitrectomy in patients with intermediate uveitis. Funatsu H. 2006. Schaal S. Harbour JW.26:5-13. Mingels A. Vitrectomy for diffuse diabetic macular edema associated with a taut premacular posterior hyaloid. Agarwal A.27:1090-1096. Ophthalmology. et al. et al.16:209-210. Pars plana vitrectomy for chronic pseudophakic cystoid macular edema. 1990. Wiechens B.140:295-301. 2005. Vitrectomy surgery increases oxygen exposure to the lens: a possible mechanism for nuclear cataract formation.120:302-307. 1999. Holekamp NM. 79. Smiddy WE. Hoerauf H. MA: Elsevier Inc. Williams GA. 94. Schadt M.130:178-186. Gentile RC. Bruggemann A.: Taut internal limiting membrane causing diffuse diabetic macular edema after vitrectomy: clinicopathological correlation. et al. Pars plana vitrectomy in cystoid macular edema of different forms of chronic uveitis. et a. 2010. et al. 75. 83. 2009. Pars plana vitrectomy. 2008. Optical coherence tomography for evaluating diabetic macular edema before and after vitrectomy.92:1102–1111. Trans Ophthalmol Soc UK. Int Ophthalmol. Vitreoretinal surgery for cystoid macular edema associated with retinitis pigmentosa. Izuta H. Sararols L. collaborative. 1987. 80. 88.