New progress of diagnosis and treatment in pseudophakic cystoid macular edema

Abstract

Pseudophakic cystoid macular edema (PCME) is one of the most common complications of cataract surgery.It is the main cause of postoperative visual loss.PCME pathogenesis is unclear yet, inflammation is supposed to be an important cause.Systemic or local diseases, and complicated surgical operations may increase the risk of PCME.Diabetes is the most common independent risk factor, and the risk of PCME is closely related to severity of preoperative diabetes.Typical clinical symptoms of PCME include acute vision loss after surgery.In PCME eyes, fundus fluorescein angiography (FFA) can show the petal-like spots characteristically, and visual disc dot staining can be seen later.Cystoid macular edema (CME) first appears in the inner nuclear layer (INL) and gradually develops in the outer plexiform layer (OPL). Finally, fluid accumulates in the subretinal space.Besides, optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) have new advances in differential diagnosis between PCME and diabetic macular edema (DME). In practice, topical non-steroid anti-inflammatory drugs (NSAIDs) or glucocorticoids are generally used as first-line treatment medicines.Anti-vascular endothelial growth factor (anti-VEGF) also attracts attention as a new treatment.Individualized prevention and treatment is required for specific types of PCME.It still lacks a common recognized treatment of PCME, and long-term efficacy of the current treatment remains to be observed more rigorous and comprehensive experimental programs are required. Key words: Pseudophakic cystoid macular edema; Diabetic macular edema; Optical coherence tomography angiography; Anti-vascular endothelial growth factor; Femtosecond laser assisted