Steroids for cystoid macular edema

A more recent retrospective analysis of 60 patients, the largest case series to date, showed a positive effect of adalimumab in 82% of these patients with different uveitis types, independent of additional systemic disease [ 11 ]. This study found that those who had been treated with infliximab and etanercept with insufficient response were effectively treated with adalimumab in 92% of cases. Another interesting finding was that patients pretreated with other TNF agents still had good results; thus, it is reasonable to switch to another TNF agent if the first was ineffective. In this study, no major infections nor serious complications known to TNF inhibitors (demyelinating disease, reactivation of TB) occurred. This is a significant finding, as adalimumab may thus be a better option than infliximab, although follow-up was short and the study’s power would need to be increased in a further study.

In this study, there were some social and psychological limitations that prevented us from obtaining the uncontrolled IOP that required the elimination of all the therapeutic lines and left the patients without therapy for several weeks and this somehow was not possible to achieve. All prostaglandin analogue drops were discontinued in all patients for a minimum of 1 week before surgery to decrease the risk of failure and inflammation postoperatively. Surgery was performed for all patients under general anesthesia as indicated by the anesthesia department in our clinic, but we believe it could be done using local anesthesia.

Post-operative restrictions are for 4 weeks after surgery and include:

• Anything that creates a Valsalva Maneuvers such as coughing, sneezing, blowing your nose, straining with bowel movements or exertion, and some of the following:
• Bending at the waist putting your head below your belt line (such as bending to tie your shoes).  Bending at the knees with your head up is allowed.
• Heavy lifting greater than 15-20 lbs.
• Strenuous activity (including lifting weights, running, yoga, pilates, aerobics, yard work, snow shoveling, laundry, housecleaning, sexual intercourse) is not recommended as it will increase your risk of developing a retina tear or detachment.  Walking, for exercise, after surgery is allowed (in patients who do not require post-operative head down position).
• Showering is allowed immediately after surgery but be sure to keep your eyes closed to prevent shower water from entering your eye.
• Swimming after surgery should be avoided for 4 weeks.  You may go into a pool (not under water for the first 4 weeks).
• Working restrictions are job dependent.  Patients with desk jobs or who perform light stationary office work may sometimes resume work 2-3 days after surgery. Patients with jobs that require heavy lifting or strenuous activity may be required to be out of work for 2-4 weeks. Ask your physician about your individual work restrictions. We will be happy to provide you with a doctor’s note for your work and/or complete your temporary disability paperwork.
• Driving restrictions will be dependent on your post-operative vision and should be discussed with your physician after surgery.


*Please note that this information is for illustrative purposes only, providing a general overview on the topics listed. For any specific questions or concerns regarding your condition, please contact our office so that you can consult with the appropriate person or department to address your needs.

Vision loss from edematous macular conditions remains a significant problem. The mainstay of treatment for these conditions, thermal laser photocoagulation, carries the risk of tissue damage. Furthermore, many conditions are not amenable to laser therapy.

This has led to the advent of intravitreal steroid injection in an attempt to better manage macular edematous conditions and preserve vision. Recent research has demonstrated benefits from this new therapeutic approach and, in time, there should be clear indications as to the proper usage of intravitreal steroid injections for the management of edematous macular diseases.

Dr. Vollmer is an Instructor of Optometry at Nova Southeastern University in Ft. Lauderdale. Dr. Sowka is a Professor of Optometry at Nova Southeastern University. Special acknowledgements also go to Julio Perez, ., and Rena Cappelli, .

Steroids for cystoid macular edema

steroids for cystoid macular edema

Vision loss from edematous macular conditions remains a significant problem. The mainstay of treatment for these conditions, thermal laser photocoagulation, carries the risk of tissue damage. Furthermore, many conditions are not amenable to laser therapy.

This has led to the advent of intravitreal steroid injection in an attempt to better manage macular edematous conditions and preserve vision. Recent research has demonstrated benefits from this new therapeutic approach and, in time, there should be clear indications as to the proper usage of intravitreal steroid injections for the management of edematous macular diseases.

Dr. Vollmer is an Instructor of Optometry at Nova Southeastern University in Ft. Lauderdale. Dr. Sowka is a Professor of Optometry at Nova Southeastern University. Special acknowledgements also go to Julio Perez, ., and Rena Cappelli, .

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