Recurrent Cystoid Macular Edema - 2025 01 10 - Kimberly Jun скачать в хорошем качестве

Recurrent Cystoid Macular Edema - 2025 01 10 - Kimberly Jun

This presentation discusses a 74-year-old male with persistent pseudophakic cystoid macular edema (CME), 14 months after cataract surgery, characterized by 12 months of blurred vision in the left eye despite treatment attempts. Clinical evaluation revealed loss of foveal contour, intraretinal cysts, subretinal fluid, and diffuse retinal thickening on OCT. Fundus photos showed foveal hypopigmentation, and fluorescein angiography (FA) demonstrated leakage in a petaloid pattern. The differential diagnosis included diabetic macular edema, retinal vein occlusion, uveitis, and tractional or dystrophic retinal conditions. The presentation emphasized the pathophysiology of pseudophakic CME, involving abnormal retinal capillary permeability and fluid accumulation in the outer plexiform and Henle layers. Management focused on the role of anti-inflammatory drops (steroids and NSAIDs) and steroid injections, though the patient experienced a steroid response and challenges with compliance. Chronic CME control was achieved with a regimen including Pred Forte, ketorolac, and dorzolamide-timolol. The teaching points underscored the importance of imaging in diagnosis, tailored therapies to manage inflammation and IOP, and compliance challenges in chronic cases. Practical insights included recognizing risk factors such as complicated surgeries and understanding the potential need for advanced treatments like vitrectomy or intravitreal injections for refractory cases.