[Differential treatment of postoperative and uveitis-induced inflammatory cystoid macular edema]. 1992

Y Guex-Crosier, and P Othenin-Girard, and C P Herbort
Hôpital Jules Gonin, Clinique ophtalmologique universitaire de Lausanne.

Twenty-five eyes (23 patients) with inflammatory cystoid macular edema (CME) (11 after cataract surgery and 14 eyes (12 patients) with uveitis) were followed in a prospective open study. The aim was to determine the efficiency of a combined treatment of Diamox (acetazolamide), Voltaren Ophtha (diclofenac, a NSAID) and Ultracortenol (prednisolone acetate) and in the case of treatment failure, the usefulness of posterior subtenon's injections of corticosteroids (Kenacort 40 mg (triamcinolone)). Seven eyes (all pseudophakic CMEs) responded successfully to the initial therapy. Their mean visual acuity improved from 0.31 +/- 0.13 to 0.93 +/- 0.08 after 18 +/- 5 days (p less than or equal to 0.001). Of the sixteen of 18 evaluable eyes that were additionally treated with a mean of 3.28 +/- 1.07 three-weekly posterior subtenon's injections, 15 eyes including all uveitis CME responded to treatment. Their mean visual acuity improved from 0.49 +/- 0.20 to 0.96 +/- 0.31 (p less than or equal to 0.001). Two patients were excluded; in 22/23 eyes the sequential treatment was successful with an overall success rate of 95% of cases (improvement of five lines on the Snellen chart or final visual acuity of 0.8 or better). Initial angiographic cystoid macular edema was comparable and significantly improved after therapy in the two treatment groups. No mean intraocular pressure rise was noted after steroid injections. Measurement of anterior chamber inflammation with the laser flare-cell meter (Kowa FC-1000) showed elevated flare in all cases which significantly decreased in both treatment groups and represented a good follow-up parameter for the effect of antiinflammatory treatment and restoration of blood-ocular barrier.(ABSTRACT TRUNCATED AT 250 WORDS)

UI MeSH Term Description Entries
D007267 Injections Introduction of substances into the body using a needle and syringe. Injectables,Injectable,Injection
D007910 Lenses, Intraocular Artificial implanted lenses. Implantable Contact Lens,Lens, Intraocular,Contact Lens, Implantable,Intraocular Lens,Intraocular Lenses,Lens, Implantable Contact
D008269 Macular Edema Fluid accumulation in the outer layer of the MACULA LUTEA that results from intraocular or systemic insults. It may develop in a diffuse pattern where the macula appears thickened or it may acquire the characteristic petaloid appearance referred to as cystoid macular edema. Although macular edema may be associated with various underlying conditions, it is most commonly seen following intraocular surgery, venous occlusive disease, DIABETIC RETINOPATHY, and posterior segment inflammatory disease. (From Survey of Ophthalmology 2004; 49(5) 470-90) Central Retinal Edema, Cystoid,Cystoid Macular Edema,Macular Edema, Cystoid,Cystoid Macular Dystrophy,Cystoid Macular Edema, Postoperative,Irvine-Gass Syndrome,Macular Dystrophy, Dominant Cystoid,Edema, Cystoid Macular,Edema, Macular,Irvine Gass Syndrome,Syndrome, Irvine-Gass
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009883 Ophthalmic Solutions Sterile solutions that are intended for instillation into the eye. It does not include solutions for cleaning eyeglasses or CONTACT LENS SOLUTIONS. Eye Drop,Eyedrop,Eyedrops,Ophthalmic Solution,Eye Drops,Drop, Eye,Drops, Eye,Solution, Ophthalmic,Solutions, Ophthalmic
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D011239 Prednisolone A glucocorticoid with the general properties of the corticosteroids. It is the drug of choice for all conditions in which routine systemic corticosteroid therapy is indicated, except adrenal deficiency states. Di-Adreson-F,Predate,Predonine,Di Adreson F,DiAdresonF
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D004008 Diclofenac A non-steroidal anti-inflammatory agent (NSAID) with antipyretic and analgesic actions. It is primarily available as the sodium salt. Diclophenac,Dichlofenal,Diclofenac Potassium,Diclofenac Sodium,Diclonate P,Dicrofenac,Feloran,GP-45,840,Novapirina,Orthofen,Orthophen,Ortofen,SR-38,Sodium Diclofenac,Voltaren,Voltarol,Diclofenac, Sodium,GP 45,840,GP45,840,SR 38,SR38

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