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Dr.S Riaz
Dr.S Riaz, Ophthalmologist
Category: Eye
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Is the cystoid malecular oedema curable?

Resolved Question:

is the cystoid malecular oedema curable?
Submitted: 8 years ago.
Category: Eye
Expert:  Dr.S Riaz replied 8 years ago.
it can be treated. The treatment varies depending upon the cause. The retinal inflammation is usually treated with anti-inflammatory medications such as cortisone or indomethacin. These are usually given as eye drops, though occasionally they must be administered as an injection or by mouth. Diuretics such as diamox may help to reduce the swelling in selected cases.

Sometimes, the vitreous (the gel that fills most of the eye) pulls on the macula causing CME. A vitrectomy (surgery to remove the vitreous gel) may be required in such cases

In some cases, the swelling and inflammation which accompanies CME can cause glaucoma, a disorder which often occurs due to increased pressure inside the eye. If this happens, the glaucoma must be treated with appropriate medications to reduce the pressure.

Anti-VEGFs intravitreal may be required in some cases. These are effective but the drawback with these injections is that they have to be repeated at about monthly intervals.

I hope, this answer helps. Thanks.

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Expert:  Dr.S Riaz replied 8 years ago.
Is the CME in your case related to cataract surgery or some other cause?
Customer: replied 8 years ago.
I think is related to cataract surgery.
Expert:  Dr.S Riaz replied 8 years ago.
Treatment is aimed at the underlying etiology.

Medical treatment modalities include the following:

Corticosteroids directly inhibit the enzyme phospholipase, blocking the formation of prostaglandins. Corticosteroids can be administered topically or orally or they can also be injected intravitreally (off-label use) or injected into the sub-Tenon space. However, corticosteroids have many systemic and ocular adverse effects such as glaucoma, and some patients become intolerant to them as a result.

NSAIDs inhibit the enzyme cyclooxygenase and are commonly employed in the prevention and treatment of CME. They are usually administered topically for approximately 3-4 months and on an as-needed basis.

Carbonic anhydrase inhibitors (CAIs), such as acetazolamide, enhance the pumping action of RPE cells, facilitating the transport of fluid across the RPE and help CME.

When vitreous strands are present at the corneal section as a result of cataract surgery then YAG YAG laser lysis of the vitreous strands has been used with some success. Sometimes surgery i.e. pars plana vitrectomy may have to be done. Thanks.

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