Management of pseudophakic cystoid macular edema

Suqin Guo, Shriji Patel, Ben Baumrind, Keegan Johnson, Daniel Levinsohn, Edward Marcus, Brad Tannen, Monique Roy, Neelakshi Bhagat, Marco Zarbin

Research output: Contribution to journalReview articlepeer-review

76 Scopus citations

Abstract

Pseudophakic cystoid macular edema (PCME) is a common complication following cataract surgery. Acute PCME may resolve spontaneously, but some patients will develop chronic macular edema that affects vision and is difficult to treat. This disease was described more than 50years ago, and there are multiple options for clinical management. We discuss mechanisms, clinical efficacy, and adverse effects of these treatment modalities. Topical non-steroidal anti-inflammatory agents and corticosteroids are widely used and, when combined, may have a synergistic effect. Intravitreal corticosteroids and anti-vascular endothelial growth factor (anti-VEGF) agents have shown promise when topical medications either fail or have had limited effects. Randomized clinical studies evaluating anti-VEGF agents are needed to fully evaluate benefits and risks. When PCME is either refractory to medical therapy or is associated with significant vitreous involvement, pars plana vitrectomy has been shown to improve outcomes, though it is associated with additional risks.

Original languageEnglish (US)
Pages (from-to)123-137
Number of pages15
JournalSurvey of ophthalmology
Volume60
Issue number2
DOIs
StatePublished - Mar 1 2015

All Science Journal Classification (ASJC) codes

  • Ophthalmology

Keywords

  • Anti-vascular endothelial growth factor
  • Corticosteroids
  • Non-steroidal anti-inflammatory agents
  • Pars plana vitrectomy
  • Pseudophakic cystoid macular edema

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