Pathogenesis of Pseudophakic Cystoid Macular Oedema

2012 ◽  
Vol 06 (05) ◽  
pp. 290
Author(s):  
Conceição Lobo ◽  
Keyword(s):  
Optical Coherence Tomography ◽  
Cataract Surgery ◽  
Inflammatory Mediators ◽  
Diagnostic Tool ◽  
Macular Oedema ◽  
Cystoid Macular Oedema ◽  
Blood Retinal Barrier ◽  
Non Invasive ◽  
Operative Complications ◽  
Inflammatory Drugs

Cystoid macular oedema (CMO) is a primary cause of reduced vision after cataract surgery even after uneventful surgery. The incidence of clinical CMO following modern cataract surgery is 1.0-2.0 % but the high number of surgeries performed worldwide makes this entity an important problem. Pre-existing conditions such as diabetes and intra-operative complications increase the risk of developing CMO post-operatively. CMO is caused by an accumulation of intra-retinal fluid in the outer plexiform and inner nuclear layers of the retina, as a result of the breakdown of the blood-retinal barrier. The mechanisms that lead to this condition are not completely understood. However, the principal hypothesis is that the surgical procedure is responsible for the release of inflammatory mediators, such as prostaglandins. Optical coherence tomography is at present an extremely useful non-invasive diagnostic tool. Guidelines for the management CMO should be focused essentially on prevention and are based on the principal pathogenetic mechanisms, including the use of anti-inflammatory drugs.

Pathogenesis of Pseudophakic Cystoid Macular Oedema

2012 ◽  
Vol 06 (03) ◽  
pp. 178
Author(s):  
Conceição Lobo ◽  
Keyword(s):  
Optical Coherence Tomography ◽  
Cataract Surgery ◽  
Inflammatory Mediators ◽  
Diagnostic Tool ◽  
Macular Oedema ◽  
Cystoid Macular Oedema ◽  
Blood Retinal Barrier ◽  
Non Invasive ◽  
Operative Complications ◽  
Inflammatory Drugs

Cystoid macular oedema (CMO) is a primary cause of reduced vision after cataract surgery even after uneventful surgery. The incidence of clinical CMO following modern cataract surgery is 1.0–2.0 % but the high number of surgeries performed worldwide makes this entity an important problem. Pre-existing conditions such as diabetes and intra-operative complications increase the risk of developing CMO post-operatively. CMO is caused by an accumulation of intra-retinal fluid in the outer plexiform and inner nuclear layers of the retina, as a result of the breakdown of the blood–retinal barrier. The mechanisms that lead to this condition are not completely understood. However, the principal hypothesis is that the surgical procedure is responsible for the release of inflammatory mediators, such as prostaglandins. Optical coherence tomography is at present an extremely useful non-invasive diagnostic tool. Guidelines for the management CMO should be focused essentially on prevention and are based on the principal pathogenetic mechanisms, including the use of anti-inflammatory drugs.

scholarly journals Comparison between Optical Coherence Tomography and Fundus Fluorescein Angiography in the Detection of Cystoid Macular Oedema in a Tertiary Eye Care Centre in Nagpur, Maharashtra

2021 ◽  
Vol 8 (40) ◽  
pp. 3459-3463
Author(s):  
Kavita Anand Dhabarde ◽  
Karuna Radhakishan Painjane ◽  
Ashok Hukumchand Madan
Keyword(s):  
Optical Coherence Tomography ◽  
Retinal Vein Occlusion ◽  
Macular Oedema ◽  
Cystoid Macular Oedema ◽  
Optical Coherence ◽  
Age Group ◽  
Care Centre ◽  
Eye Care ◽  
Fundus Fluorescein Angiography ◽  
Vein Occlusion

BACKGROUND Fundus fluorescin angiography (FFA) has been traditional gold standard for detection of cystoid macular oedema (CME) but nowadays optical coherence tomography (OCT) is used more often by to detect CME due to various conditions. Although FFA can assess CME qualitatively, OCT provides quantitative measurement of foveal thickness. The purpose of this study is to compare sensitivity of FFA and OCT for detection of CME and know the etiological distribution of CME and the ability of FFA and OCT in diagnosing CME in different aetiologies. METHODS A hospital based prospective observational diagnostic study was conducted in tertiary eye care centre in central India on 143 eyes of 103 patients. FFA and OCT findings in patients of CME diagnosed provisionally on fundus examination were studied. RESULTS Of total 103 patients studied, maximum patients 20 (19.42 %) were in age group of 55 - 59 years whereas minimum 6 (5.83 %) were in age group of 40 - 44 years. In 103 patients, 61 (59.22 %) were males and 42 (40.78 %) were females. Both eyes were involved in 41 (40.78 %) cases. Most common cause of CME was nonproliferative diabetic retinopathy (NPDR) 52 eyes (35.86 %), followed by branch retinal vein occlusion (BRVO) 32 eyes (22.06 %), then proliferative diabetic retinopathy (PDR) 14 eyes (9.6 %), central retinal vein occlusion (CRVO) 13 eyes (8.96 %). CME on OCT was seen in maximum of retinal vein occlusion patients - CRVO (84.61 %) and BRVO (84.37 %). Of 145 eyes, 114 (78.32 %) eyes had CME. CONCLUSIONS Most common cause of CME was NPDR followed by BRVO, PDR and CRVO. Sensitivity of OCT in comparison with FFA was 100 % with diagnostic accuracy of 81.38 %. Hence, one can use OCT as first modality investigation for diagnosis of CME. KEYWORDS Optical Coherence Tomography, Fundus Fluorescein Angiography, Cystoid Macular Oedema, NPDR

Optical coherence tomography angiography in pseudophakic cystoid macular oedema compared to diabetic macular oedema: qualitative and quantitative evaluation of retinal vasculature

2018 ◽  
Vol 102 (12) ◽  
pp. 1684-1690 ◽  
Author(s):  
Riccardo Sacconi ◽  
Eleonora Corbelli ◽  
Adriano Carnevali ◽  
Stefano Mercuri ◽  
Alessandro Rabiolo ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Macular Oedema ◽  
Optical Coherence Tomography Angiography ◽  
Diabetic Macular Oedema ◽  
Foveal Avascular Zone ◽  
Cystoid Macular Oedema ◽  
Control Group ◽  
Retinal Vasculature ◽  
Ophthalmological Examination ◽  
Optical Coherence

AimsTo describe optical coherence tomography angiography (OCT-A) abnormalities of patients with pseudophakic cystoid macular oedema (PCMO) before and after pharmacological resolution, compared with diabetic macular oedema (DMO) and normal eyes.MethodsIn this retrospective, observational study, 44 eyes (30 patients) were included: 15 eyes (15 patients) affected by PCMO; 14 healthy fellow eyes used as negative control group; 15 eyes (15 age-matched and sex-matched patients) with DMO used as positive control group. All patients underwent a complete ophthalmological examination at baseline, including OCT-A scans of the macula through AngioPlex CIRRUS-5000 (Carl Zeiss Meditec, Dublin, USA). Patients with PCMO and DMO were re-evaluated after the pharmacological resolution of cystoid macular oedema (CMO).ResultsDisruption of parafoveal capillary arcade and cystoid spaces in deep capillary plexus (DCP) were frequent in patients with PCMO and DMO (73% and 100%, 87% and 100%). Capillary abnormalities and non-perfusion greyish areas in DCP were more frequent in DMO (P<0.001 and P=0.014). Patients with PCMO showed a larger foveal avascular zone area in DCP at baseline (P<0.001), which significantly reduced after treatment (P=0.001). Vessel density of full-thickness retina and DCP was reduced in patients with PCMO (P=0.022 and P=0.001), and no changes were observed after treatment. Interestingly, DCP appeared less represented in patients with DMO than PCMO subjects (P=0.001).ConclusionsPatients with PCMO have an impairment of mainly DCP, partially reversible after treatment. Furthermore, we disclosed that different alterations of the retinal vasculature characterise CMO derived from two different diseases, namely PCMO and DMO, and this could be due to their distinct pathophysiology.

Bilateral fingolimod-associated macular oedema development after cataract surgery

2021 ◽  
Vol 14 (6) ◽  
pp. e240562
Author(s):  
Matthew Gillam ◽  
Theresa Richardson
Keyword(s):  
Multiple Sclerosis ◽  
Cataract Surgery ◽  
Macular Oedema ◽  
Topical Therapy ◽  
Cystoid Macular Oedema ◽  
Topical Steroids ◽  
Visual Recovery ◽  
Anti Inflammatory

Postoperative cystoid macular oedema (CMO) is a recognised complication of cataract surgery, occurring in around 1.5% of cases. It is generally managed with topical steroids or non-steroidal anti-inflammatory medications. We present a case of a patient who developed bilateral sequential CMO following bilateral sequential cataract surgery which was non-responsive to topical therapy and worsened following sub-Tenons administration of steroid. The patient took fingolimod for multiple sclerosis both prior to and during the period of cataract surgery which is known to result in the development of macular oedema in some patients. On fingolimod cessation, the oedema resolved over a period of 5 months with good visual recovery. We present this case to inform cataract surgeons of the risk of fingolimod-associated macular oedema in patients undergoing cataract surgery and to inform neurologists of the potential need to adjust treatment for patients undergoing cataract surgery.

Evaluation of optical coherence tomography as a non-invasive diagnostic tool in cutaneous wound healing

2013 ◽  
Vol 20 (1) ◽  
pp. 1-7 ◽  
Author(s):  
Monika Kuck ◽  
Helene Strese ◽  
Seyed Arash Alawi ◽  
Martina C. Meinke ◽  
Joachim W. Fluhr ◽  
...  
Keyword(s):  
Wound Healing ◽  
Optical Coherence Tomography ◽  
Diagnostic Tool ◽  
Optical Coherence ◽  
Cutaneous Wound Healing ◽  
Cutaneous Wound ◽  
Non Invasive
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