Cystoid macular edema related to cataract surgery and topical prostaglandin analogs: Mechanism, diagnosis, and management.

Gábor Holló, Tin Aung, Louis B Cantor, Makoto Aihara

Journal: Survey of ophthalmology 2021;65(5):496-512

PMID: 32092363

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Abstract

Cystoid macular edema (CME) is a form of macular retina thickening that is characterized by the appearance of cystic fluid-filled intraretinal spaces. It has classically been diagnosed upon investigation after a decrease in visual acuity; however, improvements in imaging technology make it possible to noninvasively detect CME even before a clinically significant decrease in central vision. Risk factors for the development of CME include diabetic retinopathy, retinal vein occlusion, uveitis, and cataract surgery. It has been proposed that eyes with elevated intraocular pressure after cataract surgery, including those treated with prostaglandin analog eye drops, may be at higher risk for the development of CME. We summarize the current knowledge of the molecular mechanisms underlying CME, the potential role of ocular surgery and topical glaucoma medication in increasing the risk of CME, the newly developed imaging methods for diagnosing CME, and the clinical management of CME.

Address: Glaucoma Unit, Department of Ophthalmology, Semmelweis University, Budapest, Hungary. Electronic address: [email protected].; Glaucoma Department, Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Department of Opthalmology, National University of Singapore, Singapore.; Department of Opthalmology, Indiana University School of Medicine, Indianapolis, IN, USA.; Department of Opthalmology, University of Tokyo, Tokyo, Japan.

DOI: 10.1016/j.survophthal.2020.02.004

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MeSH Terms: Cataract Extraction, Disease Management, Fluorescein Angiography, Fundus Oculi, Humans, Macular Edema, Ophthalmic Solutions, Prostaglandins, Synthetic, Visual Acuity