Cystoid macular oedema (CMO)
Definition: Thickening of macula from breakdown of blood retinal barrier leading to accumulation of intraretinal fluid at the junction of inner nuclear layer and outer plexiform layer.
Metabolic – DR, radiation
Ischaemic – RVO, DR, HTN, vasculitis, collagen dis
Mechanical – VMT, ERM
Inflammation – uveitis, post-op
Hydrostatic – hypotony, venous occlusion
Miscellaneous – macroaneurysm, telangiectasia, CNV, choroidal haemangioma, drugs (epinephrine, betaxolol, latanoprost), RP
CMO like condition – XLR, nicotinic acid, OD pit, Goldmann Favre
Symptoms: loss of vision with metamorphopsia.
Investigations: OCT macula; FFA
Observe – most cases resolve especially uncomplicated cataract surgery within 6 mths.
Diamox – for RP
Topical NSAIDs – for inflammatory causes. (also to consider as prophylaxis pre op for high risk cases)
Topical, periocular, intravitreal or oral/IV corticosteroids – for inflammatory causes.
IVT anti-VEGF – for ischaemic causes.
Immunosuppressive drugs – for inflammatory causes.
Grid Laser – for ischaemic causes.
PPV – for mechanical causes.