Treatment of CME
Therapy’s effect on CME is difficult to evaluate because of the high rate of spontaneous resolution. Pharmacologic therapy using a combination of topical corticosteroids and nonsteroidal anti-inflammatory drugs (NSAIDs) has become commonplace for prophylaxis and is supported by the medical literature for established edema. If CME is severe or refractory to topical therapy, periocular (eg, posterior sub-Tenon triamcinolone acetonide) or intraocular injection of steroid preparations are appropriate escalations of therapy. Systemic acetazolamide treatment may be successful for treatment of CME, especially in chronic cases such as associated with retinitis pigmentosa. For information about treating CME associated with diabetic retinopathy or ocular venous occlusive disease, see Chapters 5 and 6 of this volume.
If CME is associated with vitreous adhesions to the iris or a corneoscleral wound, vitrectomy or Nd:YAG laser treatment to interrupt the vitreous strands may be helpful. In cases of CME caused by epiretinal membranes or vitreomacular traction, surgical intervention may be appropriate (see Chapter 20 of this volume).
Excerpted from BCSC 2020-2021 series: Section 10 - Glaucoma. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.