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Cystoid Macular Edema

written by: Dr Mike C • edited by: Leigh A. Zaykoski • updated: 12/22/2009

Cystoid macular edema is a condition where fluid filled cysts form at the back of the retina (macula). The symptoms may involve the perception of straight lines as being wavy and the vision may take on a pinkish hue. Usually, the condition will spontaneously improve, but it can be treated.

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    Cystoid Macular Edema

    Cystoid macular edema is the name given to a condition where the macula, the cells at the back of the eye responsible for fine, central vision, are disrupted by the presence of fluid filled cysts. Usually several cysts will be involved in the condition and will result in retinal swelling (edema).

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    Symptoms Of CME

    Cystoid macular edema (CME) affects the central vision since the macula is the body in the eye responsible for the ability to see fine detail at the centre of our field of vision. Straight lines can appear to be wavy and the central vision can be blurred or otherwise distorted. Sufferers from CME may experience a pink tint to their vision and have an unusual sensitivity to light. The condition is not associated with any pain and is as likely to occur in men as women; there appears to be no ethnic association with the disease. The onset of symptoms is a gradual affair, usually. Cystoid macular edema tends to affect the vision in one eye although it may afflict both eyes. Often, the symptoms are first noted when the patient closes just the affected eye. Unlike Age-related Macular Degeneration (AMD), the damaged caused by CME will respond to treatment and the impairment to vision can be reversed.

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    Causes of CME

    The three most common causes of CME, according to the Williamson Eye Institute, are inflammatory diseases;as a consequence of eye surgery and as a result of taking certain medicines. Most cases of CME follow a surgical procedure such as cataract removal (1%) or retinal reattachment (45%).

    The condition may be associated with diabetic retinopathy; retinitis pigmentosa; vascular diseases; certain tumours; AMD; nicotinic acid; Irvine-Gas syndrome (following surgical procedures, notably for the removal of cataracts); cellular mediators (propane/epinephrine and prostaglandins) amongst others.

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    Treatment of CME

    In many cases, those suffering from CME will spontaneously recover (approximately 90% of sufferers). When this doesn’t happen, the condition is treated in a stepwise fashion. Since the inflammatory response involves prostaglandin synthesis, the first line treatment is with a prostaglandin inhibitor, such as a non-steroidal anti-inflammatory drug (i.e., aspirin, naproxen, indomethacin, and ibuprofen); the medicine is administered directly to the eye as drops. Alternatively, corticosteroid drops may be administered.

    In the event that the condition does not respond to treatment after one to two months, injections with a steroid (triamcinolone acetate) is used.