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黄斑囊样水肿

Cystoid macular edema.

作者信息

Rotsos Tryfon G, Moschos Marilita M

机构信息

Medical Retina Service, Moorfields Eye Hospital, London, UK.

出版信息

Clin Ophthalmol. 2008 Dec;2(4):919-30. doi: 10.2147/opth.s4033.

Abstract

We review the epidemiology, pathophysiology, and etiology of cystoid macular edema (CME). Inflammatory, diabetic, post-cataract, and macular edema due to age-related macular degeneration is described. The role of chronic inflammation and hypoxia and direct macular traction is evaluated in each case according to different views from the literature. The different diagnostic methods for evaluating the edema are described. Special attention is given to fluoroangiography and the most modern methods of macula examination, such as ocular coherence tomography and multifocal electroretinography. Finally, we discuss the treatment of cystoid macular edema in relation to its etiology. In this chapter we briefly refer to the therapeutic value of laser treatment especially in diabetic maculopathy or vitrectomy in some selected cases. Our paper is focused mainly on recent therapeutic treatment with intravitreal injection of triamcinolone acetonide and anti-VEGF factors like bevacizumab (Avastin), ranibizumab (Lucentis), pegaptamid (Macugen), and others. The goal of this paper is to review the current status of this treatment for macular edema due to diabetic maculopathy, central retinal vein occlusion and post-cataract surgery. For this reason the results of recent multicenter clinical trials are quoted, as also our experience on the use of intravitreal injections of anti-VEGF factors and we discuss its value in clinical practice.

摘要

我们回顾了黄斑囊样水肿(CME)的流行病学、病理生理学和病因。描述了炎症性、糖尿病性、白内障术后以及年龄相关性黄斑变性所致的黄斑水肿。根据文献中的不同观点,对每种情况下慢性炎症、缺氧以及黄斑直接牵引的作用进行了评估。介绍了评估水肿的不同诊断方法。特别关注了荧光血管造影以及黄斑检查的最现代方法,如光学相干断层扫描和多焦视网膜电图。最后,我们根据病因讨论了黄斑囊样水肿的治疗。在本章中,我们简要提及了激光治疗的治疗价值,特别是在糖尿病性黄斑病变中的应用,以及在某些特定病例中玻璃体切除术的应用。我们的论文主要聚焦于玻璃体内注射曲安奈德以及抗血管内皮生长因子(如贝伐单抗(阿瓦斯汀)、雷珠单抗(兰尼单抗)、培加他尼(麦格根)等)的近期治疗方法。本文的目的是回顾糖尿病性黄斑病变、视网膜中央静脉阻塞和白内障术后黄斑水肿的当前治疗现状。因此,引用了近期多中心临床试验的结果,以及我们使用玻璃体内注射抗血管内皮生长因子的经验,并讨论了其在临床实践中的价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/190b/2699812/57b4a8c4c5ba/co-2-919f1.jpg

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