Posters

Unremitting pseudophakic cystoid macular edema: outcome of patients treated with intravitreal corticosteroids

Poster Details

First Author: I. Carneiro PORTUGAL

Co Author(s):    I. Casal   S. Monteiro   M. Furtado   M. Lume   A. Meireles   P. Meneres     

Abstract Details

Purpose:

Pseudophakic macular edema (PME) is an important cause of painless vision loss following uneventful cataract surgery. Although the condition is usually self-limited, it may occasionally persist and lead to irreversible visual loss. In cases refractory to topical therapy (steroids and nonsteroidal anti-inflammatory drugs), intravitreal steroids are a valuable off-label treatment option. The aim of this study is to evaluate the main risk factors for refractory PME and to analyze the outcome of patients treated with intravitreal steroid injection.

Setting:

Centro Hospitalar do Porto in Porto, Portugal

Methods:

This retrospective study includes 17 eyes of 15 patients treated with intravitreal steroid injections for refractory PME, between July/2012 and February/2016. Diabetic patients with or without Diabetic Retinopathy were excluded, as well as patients with previously history of macular edema. The variables analyzed were past systemic and ocular medical history, baseline visual acuity (VA), foveal thickness (FT) measured by spectral domain optical coherence tomography (OCT), previous topical treatment performed, type of injected intravitreal steroid (intravitreal triamcinolone acetonide injection (ITAI) or dexamethasone implant–OZURDEX®), number of injections required, adverse reactions, final VA and FT and recurrence rate.

Results:

The mean age of patients was 70 years-old. Seven patients revealed previous relevant ocular history, in particular, 2 eyes with glaucoma under topical prostaglandin, 3 eyes underwent previous pars plana vitrectomy, 1 eye with previous iridotomy and 1 eye with inactive anterior uveitis. Mean baseline VA and FT was 20/50 and 498,8 µm, respectively. Thirteen eyes were treated with ITAI alone and 4 eyes with ITAI followed by intravitreal dexamethasone implant, with a mean of 1,58 injections. The mean duration of follow-up was 22,8 months [4-93 months], the mean final VA was 20/40 and mean final FT was 348,2 µm.

Conclusions:

Cystoid PME is a possible complication of uneventful cataract surgery, more frequent in eyes with relevant past ocular history. Intravitreal steroid injections appear to be a valuable treatment option for cases refractory to topical therapy. Large randomized clinical trials are still lacking to document efficacy and safety profile.

Financial Disclosure:

NONE