eMedicine Specialties > Ophthalmology > Retina

Nonpseudophakic Cystoid Macular Edema: Follow-up

Author: Daniel B Roth, MD, Assistant Clinical Professor, Department of Ophthalmology, University of Medicine and Dentistry of New Jersey
Contributor Information and Disclosures

Updated: Jan 4, 2008

Follow-up

Further Outpatient Care

  • Typically, patients with CME are evaluated 1-3 months after intervention to evaluate the efficacy of treatment.

Complications

  • Complications associated with the treatment of CME are infrequent. When a posterior sub-Tenon injection of triamcinolone is given, patients can occasionally experience a transient ptosis or subconjunctival hemorrhage. Retinal arterial occlusion after sub-Tenon steroid injections has been reported due to intravascular injection of the drug.
  • Intravitreal triamcinolone has been associated with ocular hypertension, cataract progression, retinal tear or detachment, infectious and noninfectious endophthalmitis, and lens damage.

Prognosis

  • Visual prognosis in eyes with CME depends on the etiology of the CME. If the CME resolves with treatment, visual acuity of 20/40 or better is common. However, in long-standing CME, vision is often 20/100 to 20/200.

Miscellaneous

Medicolegal Pitfalls

  • Failure to recognize CME can lead to failure to diagnose an associated disease. This can severely limit the visual prognosis if the condition is treatable. Usually, a characteristic fundus appearance allows the ophthalmologist to recognize conditions associated with CME, such as diabetic retinopathy, branch vein occlusion, or an epiretinal membrane. However, in the absence of an obvious associated condition, especially in a phakic eye, care should be taken to rule out such pathology as uveitis or a tumor. Missing such a diagnosis can have devastating consequences.
  • The use of commercially available triamcinolone acetonide is not approved for intraocular injection; however, triamcinolone acetonide is commonly used at the discretion of the treating physician as an off-label use. This use has become accepted clinical practice and has an acceptably low-risk profile. Nevertheless, specific ophthalmic preparations of triamcinolone and other long-acting steroid implants are being developed.
 


More on Nonpseudophakic Cystoid Macular Edema

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References
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Further Reading

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Keywords

nonpseudophakic CME, cystoid macular edema, CME, macular edema, non-pseudophakic cystoid macular edema, non-pseudophakic CME, Irvine-Gass syndrome, macula, vision loss

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Contributor Information and Disclosures

Author

Daniel B Roth, MD, Assistant Clinical Professor, Department of Ophthalmology, University of Medicine and Dentistry of New Jersey
Daniel B Roth, MD is a member of the following medical societies: American Academy of Ophthalmology, American Medical Association, and American Society of Retina Specialists
Disclosure: Nothing to disclose.

Medical Editor

Vytautas A Pakainis, MD, Chief of Ophthalmology, Dorn Veterans Administration Medical Center, Professor of Ophthalmology, Ophthalmology, University of South Carolina School of Medicine
Vytautas A Pakainis, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and South Carolina Medical Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Simon K Law, MD, PharmD, Assistant Professor of Ophthalmology, Jules Stein Eye Institute; Chief of Section of Ophthalmology Surgical Services, Department of Veterans Affairs Healthcare Center, West Los Angeles
Simon K Law, MD, PharmD is a member of the following medical societies: American Academy of Ophthalmology, American Glaucoma Society, and Association for Research in Vision and Ophthalmology
Disclosure: Nothing to disclose.

Managing Editor

Steve Charles, MD, Director of Charles Retina Institute; Clinical Professor, Department of Ophthalmology, University of Tennessee College of Medicine
Steve Charles, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Retina Specialists, Club Jules Gonin, Macula Society, and Retina Society
Disclosure: Alcon Laboratories Consulting fee Consulting

CME Editor

Lance L Brown, OD, MD, Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri
Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD, Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences
Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology
Disclosure: Nothing to disclose.

 
 
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