Development Of Macular Edema Research Articles

Time-sequential correlations between diabetic kidney disease and diabetic retinopathy in type 2 diabetes - an 8-year prospective cohort study.

To investigate the time-sequential correlations between progression/remission of diabetic kidney disease (DKD) and development of diabetic retinopathy (DR) or diabetic macular oedema (DME) in type 2 diabetes (T2D). This was an 8-year prospective cohort study in which 576 patients with T2D and microalbuminuria from one medical centre in Taiwan were recruited. Progression of microalbuminuria was defined as shift of urinary albumin/creatinine ratio (ACR) into 300mg/g or more; remission of microalbuminuria was defined as having a urinary ACR less than 30mg/g in at least two of three tests over a period of 6months. Cox regression analysis was used to evaluate the hazard ratios (HRs) for progression or remission of microalbuminuria on development of any DR, proliferative DR (PDR) and DME. After adjusting for baseline characteristics , remission of microalbuminuria was a significant protecting factor for development of PDR (HR=0.290, 95% CI: 0.102-0.826, p=0.020) and DME (HR=0.404, 95% CI: 0.188-0.864, p=0.020). After further adjustment for the mean follow-up HbA1c and systolic blood pressure, remission of microalbuminuria was still a significant protecting factor for development of PDR (HR=0.348, 95% CI: 0.122-0.992, p=0.048). Remission of microalbuminuria was an independent protecting factor for development of PDR and DME. Aggressive treatment for DKD might help prevent the progression of DR.

Macular and Peripapillary Optical Coherence Tomography Angiography Metrics Predict Progression in Diabetic Retinopathy: A Sub-analysis of TIME-2b Study Data

To identify optical coherence tomography angiography (OCTA)-derived vessel metrics of the macula and optic nerve head (ONH) that predict diabetic retinopathy (DR) disease progression. Secondary analysis of clinical trial data. This was a sub-analysis of prospectively collected data from 73 subjects that participated in the TIME-2b study (Aerpio Pharmaceuticals), a multicenter clinical trial for patients with moderate-to-severe DR treated with AKB-9778 and followed over a 12-month period. Eligible subjects were tested every 3months with color fundus photography, spectral-domain OCT, and slit-lamp biomicroscopy. OCTA of the macula and ONH was obtained for a subset of patients enrolled at participating sites. En face, full-depth retinal projections centered at the macula were analyzed for multiple metrics including foveal avascular zone (FAZ) area and perimeter, nonperfusion area, vessel density (VD), and presence of intraretinal microvascular abnormalities (IRMA). VD of the radial peripapillary capillaries was evaluated in 4 quadrants surrounding the optic disc for ONH images. Progression was defined as a ≥2-step increase in DR severity scale score or development of diabetic macular edema. Over a follow-up period of 12months, 15 of 73 (20.5%) subjects progressed. At pretreatment baseline, larger FAZ area, presence of IRMA, and reduced peripapillary VD in the superior temporal and inferior temporal regions were significantly associated with increased odds of progression. FAZ area and temporal peripapillary VD are predictors of DR progression. OCTA metrics may improve progression risk assessment in DR when compared to established risk factors alone.

Retinopathy Phenotypes in Type 2 Diabetes with Different Risks for Macular Edema and Proliferative Retinopathy.

Our group reported that three diabetic retinopathy (DR) phenotypes: A, characterized by low microaneurysm turnover (MAT < 6) and normal central retinal thickness (CRT); B, low MAT (<6) and increased CRT, and C, high MAT (≥6), present different risks for development of macular edema (DME) and proliferative retinopathy (PDR). To test these findings, 212 persons with type 2 diabetes (T2D) and mild nonproliferative retinopathy (NPDR), one eye per person, were followed for five years with annual visits. Of these, 172 completed the follow-up or developed an outcome: PDR or DME (considering both clinically significant macular edema (CSME) and center-involved macular edema (CIME)). Twenty-seven eyes (16%) developed either CSME (14), CIME (10), or PDR (4), with one eye developing both CSME and PDR. Phenotype A showed no association with development of vision-threatening complications. Seven eyes with phenotype B and three with phenotype C developed CIME. Phenotype C showed higher risk for CSME development, with 17.41 odds ratio (p = 0.010), compared with phenotypes A + B. All eyes that developed PDR were classified as phenotype C. Levels of HbA1c and triglycerides were increased in phenotype C (p < 0.001 and p = 0.018, respectively). In conclusion, phenotype C identifies eyes at higher risk for development of CSME and PDR, whereas phenotype A identifies eyes at very low risk for vision-threatening complications.

Steroidal versus non-steroidal eye drops in prevention of cystoid macular edema after cataract extraction in diabetic patients

Background: Cystoid macular edema (CME) is addressed as one of the most important complication responsible for suboptimal visual acuity outcome after cataract surgery. Objective: Comparison between topical steroids versus NSAIDs regarding ability to reduce CME after uneventful cataract surgery of foldable intraocular lens (IOL) implantation in diabetic patients. Patients and methods: In this study, 30 patients underwent phacoemulsification surgery with posterior chamber foldable intraocular lens implantation in Ophthalmology Department, Al-AzharUniversityHospital between December 2017 and November 2018. Patients were randomly categorized into 2 groups. Group 1: Nepafenac eye drops (0.1%) 3 times daily for one month, Group 2: Prednisolone eye drops (1%) 5 times daily for one month. Results: At the end of the follow up, foveal thickness changes in optical coherence tomography (OCT) were found to be slightly less in the no steroidal anti-inflammatory eye drops (NSAIDs) group than in the steroidal group with no significant change in the final visual outcome between the two groups. Conclusion: There was no significant statistical difference between NSAIDs drops and steroids drops in prevention of development of pseudophakic macular edema post cataract surgery.

Fasting plasma glucose variability is an independent risk factor for diabetic retinopathy and diabetic macular oedema in type 2 diabetes: An 8-year prospective cohort study.

Long-term stability in plasma glucose may affect the development of diabetic retinopathy (DR) and diabetic macular oedema (DMO). To investigate the associations between glycaemic variability and the development of DR and DMO in type 2 diabetes (T2D). An 8-year prospective cohort study. 2005 patients with T2D. DR and DMO were detected with non-mydriatic fundus photography. The visit-to-visit variability of fasting glucose or HbA1c was calculated as the standard deviation (SD) or coefficient of variation (CV = SD/mean) of all records during the follow-up periods or before the onset of the targeted event. Cox regression analysis was used to evaluate the hazard ratios (HRs) for new-onset DR, proliferative diabetic retinopathy (PDR), and DMO. After adjusting for the baseline and mean follow-up values, the SD and CV of fasting glucose during the follow-up periods were both correlated with the development of PDR (SD: HR = 1.011, P = .005; CV: HR = 6.858, P < .001), and DMO (SD: HR = 1.008, P = .038; CV: HR = 4.027, P = .017). As for HbA1c, neither the SD nor CV was correlated with the development of DR, PDR, or DMO (P > .05 for all). High visit-to-visit fasting glucose variability was associated with new-onset PDR and DMO, independent of baseline and mean follow-up fasting glucose and HbA1c in T2D. Long-term stability in plasma glucose is important for reducing the risk of the development and progression for DR and DMO.

Relationship of Epiretinal Membrane Formation and Macular Edema Development in a Large Cohort of Uveitic Eyes

ABSTRACT Purpose: To identify the temporal relationship and clinical characteristics of epiretinal membrane (ERM) and macular edema (ME) formation in uveitic eyes. Methods: A total of 269 subjects (444 uveitic eyes) met study inclusion criteria. Comprehensive ophthalmic examination, spectral domain-optical coherence tomography (SD-OCT), and clinical testing were carried out. Results: Of the 444 uveitic eyes, 229 eyes (51.6%) developed an ERM, whereas 87 eyes (19.1%) developed ME. The odds ratios (ORs) of systemic disease causing uveitis and resulting in ERM and ME were significantly higher in posterior uveitis (OR 6.56, 95% CI 2.98–14.46; p < .0001) and panuveitis (OR 10.09, 95% CI 4.05–25.15; p < .0001). Temporal analysis revealed that an ERM was noted concurrently or prior to ME development in 93.8% of eyes. Conclusions: ERM and ME are primarily observed in posterior uveitis and panuveitis associated with systemic diseases. The temporal relationship highlights the importance of characterization of ERM as it relates to the development of uveitic ME.

Gender-related differences in patients treated with intravitreal anti-vascular endothelial growth factor medication for diabetic macular oedema.

Diabetes prevalence is constantly rising, involving the eyes with damage including development of diabetic macular oedema. Since 2012, intravitreal anti-vascular endothelial growth factor medication is available for diabetic macular oedema treatment. Endocrinological studies have shown that fewer women are affected by diabetes. However, when affected, they exhibit more severe diabetic complications than men. We have investigated gender-related differences in diabetic macular oedema and outcome in an ophthalmological tertiary referral hospital. We included 88 patients (54 males and 34 females) with 112 eyes (68 male and 44 female) having clinically significant diabetic macular oedema, treated with anti-vascular endothelial growth factor medication. A 1 year follow-up was performed in all patients (visual acuity and optical coherence tomography). Previous retinal surgery was an exclusion criterion, as were other retinal pathologies. The mean visual acuity and mean central retinal thickness at baseline were 0.53 logMAR (male 0.49 and female 0.595) and 469 μm (male 452 μm and female: 494 μm), respectively. After 360 days, mean visual acuity changed by -0.07 (±0.36) logMAR (male -0.11 and female +0.01) and mean central retinal thickness changed by -119 μm (male -113 μm and female -127 μm). For visual acuity, a significant difference was noted at baseline (p = 0.02) and at 1 year (p < 0.001). Males received 5.6 injections and females received 5.68 injections in 1 year. Our study showed that female patients with diabetic macular oedema were diagnosed with and treated for diabetic macular oedema at a stage when visual acuity and optical coherence tomography were worse than those in their male counterparts. This gender difference could not be reduced, despite similar numbers of injections. Female diabetic patients should therefore be assessed early for ophthalmological pathologies.

PREDICTION OF THE DEVELOPMENT OF RETINAL MORPHOLOGICAL CHANGES AFTER PHACOEMULSIFICATION BASED ON THE STATE OF THE CYTOKINE PROFILE OF INTRAOCULAR FLUID

The aim: To investigate the features of cytokine profile of intraocular fluid in patients undergoing cataract phacoemulsification and the effect of their level on the nature and frequency of early and late postoperative complications from the retina. Materials and methods: The work involved 82 patients (82 eyes) with cataract during traditional phacoemulsification on the basis of Ophthalmology department of Poltava Regional Clinical Hospital. The intraocular fluid for the study, while performing phacoemulsification of the nucleus, was collected with a single insulin syringe through the paracentesis of the cornea in the volume of 0.3-0.4 ml for the examination of TNF-α and bFGF levels. Results: It was found that the level of TNF-α intraocular fluid ranged from 1.11 pg / ml to 140.55 pg / ml; its average was 24.61 ± 5.43 pg / ml. When examining the level of bFGF in intraocular fluid, it ranged from 1.0 pg / ml to 12.54 pg / ml; its average was 3.33 ± 0.44 pg / ml. Conclusions: Comparing the levels of the effect of TNF-α and bFGF of the intraocular fluid of patients with cataracts and morphological changes of the retina after phacoemulsification revealed a direct dependence of the level of these factors on the development of macular edema.

Ways of technical science development in ophthalmology

In recent years, in the study of diabetic retinopathy the methods of medical engineering and mathematical modeling with the forecast of the course of diseases and given pathogenetic biomarkers in the lacrimal fluid have been widely used. The theoretical aspects of the research are the developed mathematical criteria. The criteria are the mathematical formulas describing objective data of digital ophthalmological equipment and levels of pathogenetic biomarkers in lacrimal fluid and blood serum. The proposed approach allows to create a decision support sys-tem for predicting the development of diabetic retinopathy and diabetic macular edema. The practical application of the mathematical model is reflected in the developed computer program that enables the ophthalmologist to work with the patient’s data in automatic mode. The use of the program for the diagnosis and prognosis of a patient with diabetic retinopathy is demonstrated. The work on the proposed method gives the opportunity to reduce the time for assessing the patient’s condition and give a timely forecast of the course of the disease, which makes it possible to approach each patient in a personalized way.

Morphological and functional condition of the macula after different types of phaco cataract surgeries

To evaluate morphological and functional condition of the macular area after different types of phaco cataract surgeries. Two groups were formed for comparative study in accordance with criteria for standardization and maximum mitigation of the impact of other factors on the condition of the retina - with standard ultrasound and hybrid (femtolaser-assisted) phacoemulsification (30 operations in each group). Examinations were performed initially, then 7-10 days, and 2-3 month after the surgery. Optical coherence tomography (OCT) and multifocal electroretinography (mfERG) were performed for evaluation of the morphological and functional condition of the macular area. There was no statistically significant dependence of linear and volumetric measures in the macular area on phaco surgery method, and the few variations were most likely related to increasing the time of ultrasound action in standard phacoemulsification. Revealed changes turned out to be significantly less marked than what is considered critical for development of macular edema. Improvement of baseline multifocal electroretinography measurements (increase of the density of retinal biopotential and decrease of latent time) just after the surgery results from the effect the lens opacification has on basic parameters, regardless of phacoemulsification technique. There were no significant differences in postsurgical measurements of multifocal electroretinography obtained in similar periods of postsurgical assessment after standard ultrasound and hybrid phacoemulsification. The results prove the safety of phaco surgery methods and the absence of negative impact of femtolaser component of hybrid phacoemulsification on structural and functional condition of central retina.

Preoperative medication for glaucoma and cataract: problems of choice

There have been multiple scientific publications reporting of cases and post-hoc analysis of relationship between the prostaglandin analogues (PA) use and postoperative macular edema development in patients underwent cataract surgery. The purpose of research is to compare effects of different groups of antihypertensive drugs on condition of central retina in patients with primary open-angle glaucoma (POAG) after phacoemulsification of cataract (PC) and combined surgeries for cataract and glaucoma. Material and methods. Analysis was carried out with data on 36 patients (49 eyes) underwent the cataract surgery on the top of POAG: group I – 12 patients (15 eyes) who were receiving antihypertensive therapy of PA before and after PC; group II – 10 patients (11 eyes) who were receiving PA therapy prior to combined surgery for cataract and glaucoma (PA were cancelled during postoperative period); group III – 14 patients (25 eyes) who were receiving antihypertensive therapy of any drug group excluding PA before and after PC. Results. The thickness in central retina of all 3 groups` patients was comparable both before and after the surgery, differences were statistically insignificant. Cross-group measurement results were also statistically insignificant. Conclusion. Findings of the study have not identified any convincing evidence that would support a change of antihypertensive drugs against POAG as a preparation for cataract surgery and during early postoperative period to reduce the risk of macular edema. The use of prostaglandins analogs does not result in conspicuous changes in thickness of macula zone of retina during postoperative period.

Incidence of cystoid macular edema following routine cataract surgery using NSAIDs alone or with corticosteroids

To evaluate the rate of cystoid macular edema development among cataract surgery patients on four different therapeutic regimens. The present study is a retrospective analysis of 5,380 eyes following uncomplicated phacoemulsification at Wake Forest University. The study period went from July 2007 to December 2012. Patients received one of four regimens, as follows: postoperative generic ketorolac 0.4% and prednisolone 1%, postoperative name-brand ketorolac 0.45% and prednisolone 1%, postoperative bromfenac 0.09% and prednisolone 1%, preoperative and postoperative bromfenac 0.09% alone. A statistical analysis was performed to assess the differences in rate of cystoid macular edema development among the four different therapeutic regimens. The diagnosis of cystoid macular edema required worsening of vision and evidence of increased macular thickness on optical coherence tomography. The overall rate of cystoid macular edema was 0.82%. Treatment by postoperative generic ketorolac 0.45% and prednisolone 1% demonstrated the highest rate of cystoid macular edema development (2.20% of the cases). Postoperative name-brand ketorolac 0.45% and prednisolone 1% exhibited intermediate rates of cystoid macular edema development (0.90% of the cases). Postoperative administration of bromfenac 0.09% and prednisolone 1% exhibited intermediate rates of cystoid macular edema development (0.44% of the cases). Preoperative and postoperative bromfenac 0.09% alone resulted in the lowest rate of cystoid macular edema development (0.09% of the cases). The rate of cystoid macular edema was significantly lower when bromfenac was used alone vs. either regimen where ketorolac and prednisolone were used (OR 0.043, 95% CI 0.002 to 0.312; p<0.001). Post-cataract surgery cystoid macular edema developed less frequently following topical non-steroidal anti-inflammatory drugs regimen compared to the other therapies evaluated. Bromfenac, without corticosteroids, achieved lower rates of cystoid macular edema vs. various combinations of non-ste-roidal anti-inflammatory drugs with corticosteroids.

Structural and Functional Criteria of Neuroprotection Effectiveness after Anti-VEGF Therapy in Patients with Neovascular Age-Related Macular Degeneration

Purpose . Estimate of clinical efficacy of combined use of aflibercept and meldonium at tachyphylaxis of neovascular age-related macular degeneration (nAMD) to ranibizumab. Patients and methods. Comparative analysis of treatment results of nAMD in 25 eyes (25 patients) aged from 52 to 79 years was carried out. Main criterion for the patients inclusion was presence of nAMD resistant to intravitreal injections (IVI) of VEGF inhibitor ranibizumab with visual acuity values of not less than 0.1. Patients with different ophthalmologic pathology, accompanied by development of macular edema, with glaucoma and after any eye operations, performed during study period, were excluded from study. Before using aflibercept, all patients were treated with ranibizumab for 1.5–2 years (from 5 to 7 injections). The lack of persistent positive result was cause for change of course treatment of this patients on aflibercept (3 monthly injections) for enhance anti-vasoproliferative effect. The patients were divided into two groups — main and comparison, comparable by sex, age, visual acuity and type of choroidal neovascularization. In the main group, 3 aflibercept IVI were supplemented parabulbar injections of 0.5 ml of meldonium (with concentration of 500 mg / 5 ml) daily for 10 days. Patients of the comparison group did not receive meldonium. Results. The supplement of meldonium in the main group, relative to the comparison group, led to increase in 1.5 times of best corrected visual acuity, in 1.2 times of b-wave amplitude of the electroretinogram, preservation of the neuro- and pigment epithelium of retina, complete regression of neovascularization. Conclusion . Findings results evidence about clinically advisable to use meldonium in course treatment in patients with nAMD, resistant to ranibizumab, with aflibercept IVI for increase visual functions and stabilize the degenerative changes in neurosensory retina, pigment epithelium and choriocapillary layer.

FACTORS ASSOCIATED WITH THE USE OF 360-DEGREE LASER RETINOPEXY DURING PRIMARY VITRECTOMY WITH OR WITHOUT SCLERAL BUCKLE FOR RHEGMATOGENOUS RETINAL DETACHMENT AND IMPACT ON SURGICAL OUTCOMES (PRO STUDY REPORT NUMBER 4).

To determine factors associated with 360-degree laser retinopexy (360LR) during primary pars plana vitrectomy ± scleral buckle for rhegmatogenous retinal detachment (RRD) and its impact on surgical outcomes. This is a multicenter, retrospective, interventional study. Patients undergoing primary pars plana vitrectomy or primary pars plana vitrectomy + scleral buckle for noncomplex primary RRD in 2015 were evaluated. Primary outcomes were single surgery anatomical success (SSAS) and final anatomical success. Secondary outcomes included final logarithm of the minimum angle of resolution visual acuity, epiretinal membrane formation, cystoid macular edema development, and number of subsequent vitrectomies. Multivariate regressions were performed. Two thousand two hundred and forty-eight surgeries by 61 surgeons were included; of which, 516 underwent 360LR. Younger age (P = 0.01), more retinal breaks (P = 0.01), more extensive RRD (P < 0.001), and surgeon ID (P < 0.001) were significantly associated with 360LR. No significant associations between 360LR and single surgery anatomical success (P = 0.44), epiretinal membrane formation (P = 0.14), cystoid macular edema development (P = 0.28), or number of subsequent vitrectomies (P = 0.41) were found. Controlling for case complexity, 360LR was significantly associated with lower final anatomical success (P < 0.001) and worse final logarithm of the minimum angle of resolution visual acuity (P < 0.001). Multiple factors influenced whether 360LR was performed during primary pars plana vitrectomy ± scleral buckle for RRD. However, 360LR was not associated with improved surgical outcomes, and in fact, it may be associated with poorer outcomes.

Роль аналогов простагландинов в развитии макулярного отека при периоперационном применении у больных катарактой, сочетанной с первичной открытоугольной глаукомой

Роль аналогов простагландинов в развитии макулярного отека при периоперационном применении у больных катарактой, сочетанной с первичной открытоугольной глаукомой

OUR VIEW ON THE ETIOLOGICAL CAUSES OF IRWIN-GASS SYNDROME AFTER CATARACT SURGERY

The transition to small incision surgery and the introduction of this type of surgery in the period from the late 80's to 2005 enabled to reduce the share of postoperative complications, but despite the significant achievements of this surgical approach, some patients have unsatisfactory postoperative results due to the development of retinal macular oedema. Even at the present stage of the development of medical science, there has been no universally recognized theory of the aetiology and pathogenesis of Irwin-Gass syndrome. Despite the numerous reports on the aspects of macular oedema development following cataract phacoemulsification, a number of issues related to the mechanism of its development and predictability are remaining unexplored, and in particular the role of MMA and morphometric indicators in this process. Therefore, the purpose of this study was to analyze the causes of Irvine-Gass syndrome by comparing and evaluating the development of complications in the pre- and postoperative period, CDE, duration of intraocular surgery, the level of intraocular fluid prostanoids, density of corneal endothelial cells and morphofunctional cells. The enzyme-linked immunosorbent assays have demonstrated that among the leading risk factors for macular edema following surgical treatment of cataract patients are the ultrasound power, the duration of surgery, the state of the prostanid system of vision apparatus and their ratio coefficient. The results obtained can contribute to solving a specific scientific problem of ophthalmology, the prediction of macular edema after surgical treatment for patients with age-related cataracts.

Cystoid macular edema with prostaglandin analogue use after uneventful cataract surgery in glaucoma patients

To evaluate the effect of postoperative latanoprost administration on central macular thickness (CMT) after uneventful cataract surgery in glaucoma patients. Farabi Eye Hospital, Tehran, Iran. Prospective randomized clinical trial. In this single-masked trial, glaucoma patients treated with latanoprost who had no other risk factor for the development of pseudophakic macular edema were randomly allocated to continuation of latanoprost or discontinuation of the drop after uneventful cataract surgery. At baseline and postoperatively at 1month and 3months, patients had complete ocular examinations and CMT measurements using optical coherence tomography. The main outcome measure was the change in the CMT between baseline measurements and postoperative measurements at 1month and 3months. One hundred fifty-six eyes (latanoprost 76; discontinuation 80) finished the trial. There were no differences in baseline patient demographics or characteristics, including the CMT, between the two groups. There was transient increase in the mean CMT by 12μm±49 (SD) in the latanoprost group at 1month (P=.03); however, the value returned to baseline by 3months (6±55μm; P=.27). The between-group difference in the mean change in the CMT from baseline was -3.1μm (95% confidence interval [CI], -18.4 to 12.0; P=.68) after 1month and -10.5μm (95% CI, -26.6 to 5.5; P=.19) after 3months; the differences were not significant. Latanoprost administration after cataract surgery had no measurable effect on macular thickness.

Emerging therapies in the management of macular edema: a review.

Macular edema (ME) is a major complication of several vascular and inflammatory retinal diseases. Multiple mechanisms are implicated in its development and lead to visual impairment that could be reversible (the acute stages) or not reversible (long-standing ME). For this reason, an effective approach to the treatment of ME is of paramount importance in order to prevent irreversible damage of visual function. In this review, we discuss the management of ME and, in particular, current data of studies and clinical trials about drugs that have already been evaluated or are under investigation in the management of ME. Although several diseases could lead to the development of ME, we focus on the three main causes: diabetic retinopathy (DR), retinal vein occlusion (RVO), and uveitis. The introduction into clinical practice of anti-vascular endothelial growth factor injections (ranibizumab and aflibercept) and dexamethasone implants has revolutionized the treatment of ME secondary to DR and RVO. However, new drugs are needed in the treatment of resistant forms of ME secondary to DR and RVO. A fluocinolone acetonide implant has been approved by the US Food and Drug Administration for the treatment of diabetic ME but not for RVO. Furthermore, brolucizumab and abicipar pegol have been shown to be effective in preliminary studies and have the chance to be approved soon for diabetic ME treatment. In ME secondary to uveitis, a crucial role is played by corticosteroids and non-biologic immunomodulatory drugs. However, several new biologic agents are under investigation in different clinical trials and could be important new therapeutic options in cases with a low response to first-line therapy. However, only a few of these drugs will enter the market after proving their safety and efficacy. Only after that will we be able to offer a new therapeutic option to patients affected by uveitic ME.

Inner Nuclear Layer Cystic Changes in Phakic Fellow Eyes of Patients With Acute Pseudophakic Cystoid Macular Edema

Improvements in retinal imaging have recently elucidated structural patterns in the development of macular edema, particularly involving the inner nuclear layer. Here, the authors describe two cases of isolated inner nuclear layer cystic changes in the phakic fellow eye of patients with pseudophakic cystoid macular edema. Both cases improved with treatment of their fellow eye and resolution of contralateral macular edema. The authors hypothesize potential pathomechanisms for this likely common but under-recognized phenomenon. [Ophthalmic Surg Lasers Imaging Retina. 2019;50:522-524.].

The role of sICAM-1 in the development of diabetic macular edema in patients with type 2 diabetes mellitus

The role of sICAM-1 in the development of diabetic macular edema in patients with type 2 diabetes mellitus