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与白内障手术和局部前列腺素类似物相关的囊样黄斑水肿:发病机制、诊断和治疗。

Cystoid macular edema related to cataract surgery and topical prostaglandin analogs: Mechanism, diagnosis, and management.

机构信息

Glaucoma Unit, Department of Ophthalmology, Semmelweis University, Budapest, Hungary.

Glaucoma Department, Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Department of Opthalmology, National University of Singapore, Singapore.

出版信息

Surv Ophthalmol. 2020 Sep-Oct;65(5):496-512. doi: 10.1016/j.survophthal.2020.02.004. Epub 2020 Feb 22.

Abstract

Cystoid macular edema (CME) is a form of macular retina thickening that is characterized by the appearance of cystic fluid-filled intraretinal spaces. It has classically been diagnosed upon investigation after a decrease in visual acuity; however, improvements in imaging technology make it possible to noninvasively detect CME even before a clinically significant decrease in central vision. Risk factors for the development of CME include diabetic retinopathy, retinal vein occlusion, uveitis, and cataract surgery. It has been proposed that eyes with elevated intraocular pressure after cataract surgery, including those treated with prostaglandin analog eye drops, may be at higher risk for the development of CME. We summarize the current knowledge of the molecular mechanisms underlying CME, the potential role of ocular surgery and topical glaucoma medication in increasing the risk of CME, the newly developed imaging methods for diagnosing CME, and the clinical management of CME.

摘要

囊样黄斑水肿(CME)是一种黄斑视网膜增厚的形式,其特征是出现充满囊状液体的视网膜内空间。它通常在视力下降后通过检查来诊断;然而,成像技术的改进使得即使在中央视力出现明显下降之前,也可以非侵入性地检测到 CME。CME 的发展的危险因素包括糖尿病视网膜病变、视网膜静脉阻塞、葡萄膜炎和白内障手术。有人提出,白内障手术后眼内压升高的眼睛,包括用前列腺素类似物滴眼剂治疗的眼睛,可能有更高的发生 CME 的风险。我们总结了 CME 发生的分子机制的现有知识,眼部手术和局部青光眼药物在增加 CME 风险方面的潜在作用,新开发的用于诊断 CME 的成像方法,以及 CME 的临床管理。

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