Purpose: To evaluate the novel, surgical technique of cystoid macular edema puncture (CMEP) in patients with longstanding cystoid macular edema refractory to standard treatments.
Design: Interventional, retrospective case series
Methods: Retrospective review of patients with chronic cystoid macular edema from vascular retinopathy who failed maximal medical or surgical therapy and underwent pars plana vitrectomy and cystoid macular edema puncture. Clinical findings, best-corrected Snellen visual acuity, stereo color fundus photography, intravenous fluorescein angiograms, and optical coherence tomography were obtained before and after therapy to evaluate the efficacy and safety of the treatment.
Results: Seven patients were included in the study. Cystoid macular edema was due to diabetic retinopathy in five patients, central retinal vein occlusion in one patient, and branch retinal vein occlusion in one patient. All patients failed preoperative intravitreal steroids and two patients also had focal grid photocoagulation. Three patients failed previous pars plana vitrectomy with elevation of the posterior hyloid, internal limiting membrane peeling, and intravitreal steroid injection. The median time to CMEP was 488 days. Resolution or improvement of cystoid edema occurred in all patients as determined by fluorescein angiography and/or optical coherence tomography. However, visual acuity was unchanged in five patients, declined in one patient, and stable in one patient.
Conclusions: While cystoid macular edema does improve quantitatively after CMEP, the technique fails to improve visual acuity in patients.
- cystoid macular edema
- cystoid puncture
- diabetic retinopathy
- macular edema
- retinal vein occlusion