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Pseudophakic cystoid macular edema associated with extrafoveal vitreoretinal traction.

Martinez MR, Ophir A - Open Ophthalmol J (2011)

Bottom Line: Excluded were eyes that either had another vitreoretinopathy that could affect the analysis or had undergone an intravitreal intervention.Three eyes (three patients) with macular edema following uneventful cataract surgery were detected to be associated with multifocal extrafoveal vitreoretinal traction sites in each.Retinal edema that was underlying each of the traction sites in all eyes was in continuum in at least one site per eye with the central macular edema, thus manifesting as diffuse macular edema.

View Article: PubMed Central - PubMed

Affiliation: Division of Ophthalmology, Hillel-Yaffe Medical Center, Hadera.

ABSTRACT

Purpose: To describe an association between extrafoveal vitreoretinal traction and intractable chronic pseudophakic cystoid macular edema (CME) by the use of optical coherence tomography (OCT).

Methods: In a retrospective case series study, charts and OCT findings of patients who had postoperative recalcitrant pseudophakic CME for at least 6 months and vitreoretinal traction membranes were analyzed. Excluded were eyes that either had another vitreoretinopathy that could affect the analysis or had undergone an intravitreal intervention.

Results: Three eyes (three patients) with macular edema following uneventful cataract surgery were detected to be associated with multifocal extrafoveal vitreoretinal traction sites in each. Retinal edema that was underlying each of the traction sites in all eyes was in continuum in at least one site per eye with the central macular edema, thus manifesting as diffuse macular edema.

Conclusion: Chronic pseudophakic macular edema may be related to extrafoveal vitreoretinal traction.

No MeSH data available.


Related in: MedlinePlus

Extrafoveal multifocal vitreoretinal traction associated with pseudophakic CME as detected by the SD-OCT (Pt. 2). A + B. The clinical picture and the accompanying small false-color map (below the fundus picture), as detected by 8.2mm X 3 mm scan area (the colored rectangle) illustrate macular edema (red and yellow colors). The blue crosses, one in A and one in B, demonstrate two extrafoveal vitreoretinal traction sites. One retinal edema site (in B) is shown by the false-color map to be in continuum with the central macula. C + D. The B-mode (C) and the 3-D image reconstruction (D) reveal two sites under traction by one continuous vitreous membrane (arrow). Each traction site is manually marked by a vertical white line, and its retinal location is shown automatically by yellow crosses in A & B. The optic nerve (ON) is seen in D.
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Figure 2: Extrafoveal multifocal vitreoretinal traction associated with pseudophakic CME as detected by the SD-OCT (Pt. 2). A + B. The clinical picture and the accompanying small false-color map (below the fundus picture), as detected by 8.2mm X 3 mm scan area (the colored rectangle) illustrate macular edema (red and yellow colors). The blue crosses, one in A and one in B, demonstrate two extrafoveal vitreoretinal traction sites. One retinal edema site (in B) is shown by the false-color map to be in continuum with the central macula. C + D. The B-mode (C) and the 3-D image reconstruction (D) reveal two sites under traction by one continuous vitreous membrane (arrow). Each traction site is manually marked by a vertical white line, and its retinal location is shown automatically by yellow crosses in A & B. The optic nerve (ON) is seen in D.

Mentions: Three patients, aged 51-78 years old, with chronic pseudophakic CME in one eye, in which any other potential clinical cause for the edema was not detected, were diagnosed using OCT to have extrafoveal multifocal vitreoretinal traction sites in each eye. Patients’ characteristics and OCT findings are summarized in Table 1. Both the B-mode video clips of the SD-OCT and their 3-D image reconstructions enabled fast and unambiguous detection of extrafoveal traction membranes in eyes No. 1 & 2 (Figs. 1, 2). The retinal edema that underlined each of the vitreoretinal traction sites in Eye No. 1, including the edema that was associated with the vitreopapillary traction, was in continuum with the central macular edema, thus attaining a pattern of diffuse macular edema. This observation could be depicted from the macular maps and the 3-D image reconstructions of the SD-OCT (Fig. 1 and supplementary video clip 1). Eye No. 2 had Irvine-Gass syndrome with a swollen disc at the early postoperative period. Four years later, using SD-OCT, the perifoveal area was mildly thickened, and a pseudohole at the central macula with adjacent ERM was apparent. The retinal edema that underlined one of the two detectable traction sites was in continuum with the central macular edema in that eye (Fig. 2).


Pseudophakic cystoid macular edema associated with extrafoveal vitreoretinal traction.

Martinez MR, Ophir A - Open Ophthalmol J (2011)

Extrafoveal multifocal vitreoretinal traction associated with pseudophakic CME as detected by the SD-OCT (Pt. 2). A + B. The clinical picture and the accompanying small false-color map (below the fundus picture), as detected by 8.2mm X 3 mm scan area (the colored rectangle) illustrate macular edema (red and yellow colors). The blue crosses, one in A and one in B, demonstrate two extrafoveal vitreoretinal traction sites. One retinal edema site (in B) is shown by the false-color map to be in continuum with the central macula. C + D. The B-mode (C) and the 3-D image reconstruction (D) reveal two sites under traction by one continuous vitreous membrane (arrow). Each traction site is manually marked by a vertical white line, and its retinal location is shown automatically by yellow crosses in A & B. The optic nerve (ON) is seen in D.
© Copyright Policy - open-access
Related In: Results  -  Collection

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Figure 2: Extrafoveal multifocal vitreoretinal traction associated with pseudophakic CME as detected by the SD-OCT (Pt. 2). A + B. The clinical picture and the accompanying small false-color map (below the fundus picture), as detected by 8.2mm X 3 mm scan area (the colored rectangle) illustrate macular edema (red and yellow colors). The blue crosses, one in A and one in B, demonstrate two extrafoveal vitreoretinal traction sites. One retinal edema site (in B) is shown by the false-color map to be in continuum with the central macula. C + D. The B-mode (C) and the 3-D image reconstruction (D) reveal two sites under traction by one continuous vitreous membrane (arrow). Each traction site is manually marked by a vertical white line, and its retinal location is shown automatically by yellow crosses in A & B. The optic nerve (ON) is seen in D.
Mentions: Three patients, aged 51-78 years old, with chronic pseudophakic CME in one eye, in which any other potential clinical cause for the edema was not detected, were diagnosed using OCT to have extrafoveal multifocal vitreoretinal traction sites in each eye. Patients’ characteristics and OCT findings are summarized in Table 1. Both the B-mode video clips of the SD-OCT and their 3-D image reconstructions enabled fast and unambiguous detection of extrafoveal traction membranes in eyes No. 1 & 2 (Figs. 1, 2). The retinal edema that underlined each of the vitreoretinal traction sites in Eye No. 1, including the edema that was associated with the vitreopapillary traction, was in continuum with the central macular edema, thus attaining a pattern of diffuse macular edema. This observation could be depicted from the macular maps and the 3-D image reconstructions of the SD-OCT (Fig. 1 and supplementary video clip 1). Eye No. 2 had Irvine-Gass syndrome with a swollen disc at the early postoperative period. Four years later, using SD-OCT, the perifoveal area was mildly thickened, and a pseudohole at the central macula with adjacent ERM was apparent. The retinal edema that underlined one of the two detectable traction sites was in continuum with the central macular edema in that eye (Fig. 2).

Bottom Line: Excluded were eyes that either had another vitreoretinopathy that could affect the analysis or had undergone an intravitreal intervention.Three eyes (three patients) with macular edema following uneventful cataract surgery were detected to be associated with multifocal extrafoveal vitreoretinal traction sites in each.Retinal edema that was underlying each of the traction sites in all eyes was in continuum in at least one site per eye with the central macular edema, thus manifesting as diffuse macular edema.

View Article: PubMed Central - PubMed

Affiliation: Division of Ophthalmology, Hillel-Yaffe Medical Center, Hadera.

ABSTRACT

Purpose: To describe an association between extrafoveal vitreoretinal traction and intractable chronic pseudophakic cystoid macular edema (CME) by the use of optical coherence tomography (OCT).

Methods: In a retrospective case series study, charts and OCT findings of patients who had postoperative recalcitrant pseudophakic CME for at least 6 months and vitreoretinal traction membranes were analyzed. Excluded were eyes that either had another vitreoretinopathy that could affect the analysis or had undergone an intravitreal intervention.

Results: Three eyes (three patients) with macular edema following uneventful cataract surgery were detected to be associated with multifocal extrafoveal vitreoretinal traction sites in each. Retinal edema that was underlying each of the traction sites in all eyes was in continuum in at least one site per eye with the central macular edema, thus manifesting as diffuse macular edema.

Conclusion: Chronic pseudophakic macular edema may be related to extrafoveal vitreoretinal traction.

No MeSH data available.


Related in: MedlinePlus