ABSTRACT
Pseudophakic cystoid macular edema (PCME) is a common complication following cataract surgery. Acute PCME may resolve spontaneously, but some patients will develop chronic macular edema that affects vision and is difficult to treat. This disease was described more than 50 years ago, and there are multiple options for clinical management. We discuss mechanisms, clinical efficacy, and adverse effects of these treatment modalities. Topical non-steroidal anti-inflammatory agents and corticosteroids are widely used and, when combined, may have a synergistic effect. Intravitreal corticosteroids and anti-vascular endothelial growth factor (anti-VEGF) agents have shown promise when topical medications either fail or have had limited effects. Randomized clinical studies evaluating anti-VEGF agents are needed to fully evaluate benefits and risks. When PCME is either refractory to medical therapy or is associated with significant vitreous involvement, pars plana vitrectomy has been shown to improve outcomes, though it is associated with additional risks.
Subject(s)
Macular Edema/drug therapy , Pseudophakia/drug therapy , Angiogenesis Inhibitors/therapeutic use , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Cataract Extraction/adverse effects , Drug Therapy, Combination , Glucocorticoids/therapeutic use , Humans , Macular Edema/etiology , Pseudophakia/etiology , Risk Factors , Vascular Endothelial Growth Factor A/antagonists & inhibitors , Vitrectomy/methodsABSTRACT
We report a case of transient bilateral visual loss in a 27-year-old patient with a diagnosis of bipolar disorder after right unilateral electroconvulsive therapy that occurred immediately after her first session and resolved within 24 hours. We discuss possible mechanisms for this adverse effect.
