CME - Chronic Pseudophakic
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74-year-old woman has chronic cystoid macular edema in the left eye. She has had vision loss intermittently in that eye since March of 2006 (2 years ago). The right eye, unfortunately, lost vision from a central retinal vein occlusion in 2003. Her cataract surgery was done in the left eye in September of 2005. She is on Acular and Pred Forte in the left eye twice a day. Her vision in the left eye seems fine.
VISUAL ACUITY: OD: 20/400; OS: 20/40. IOP: OS: 13. The left eye has a posterior chamber intraocular lens is in good position.
EXTENDED OPHTHALMOSCOPY:
OS: Vertical C/D ratio is 0.3. There is 2+ cystoid macular edema with patchy retinal hemorrhages.
OCT SCAN: The OCT scan shows worsened cystoid macular edema with a central foveal thickness of 383 microns compared to the last visit when it was 301 microns.
FLUORESCEIN ANGIOGRAM: FA shows a cystoid macular edema with late leakage into the fovea. There are rare microaneurysms.
IMPRESSION:
1. BACKGROUND DIABETIC RETINOPATHY – LEFT EYE
2. CHRONIC PSEUDOPHAKIC CYSTOID MACULAR EDEMA – LEFT EEY
DISCUSSION: I explained to the patient that she does unfortunately have chronic macular edema associated with the cataract surgery a few years ago. I suggested we give her a posterior sub-Tenon Kenalog shot. She tolerated that fine before and did not have the problem with intraocular pressure rise. I injected the eye today without any difficulty. She is to return for a check in six weeks, sooner should she notice any problem. She will see you back periodically.
3 month follow-up:
March 11, 2008. This pleasant 74-year-old woman has macular edema in the left eye. She is also diabetic and pseudophakic. She had a good response to posterior sub-Tenon Kenalog shot in March of 2006. I re-treated her in January of 2008 and her vision has improved some.
VISUAL ACUITY: OS 20/30. IOP: OS 22. The posterior chamber intraocular lens is in good position.
EXTENDED OPHTHALMOSCOPY:
OS: Vertical C/D ratio is 0.3. There is 2+ retinal hemorrhages. The fovea looks to have flattened out some.
OCT SCAN: The OCT scan confirms a decreased macular edema. The central foveal thickness is 264 microns, which is better than last visit when it was 383 microns.
IMPRESSION:
1. RESOLVED CYSTOID MACULAR EDEMA – LEFT EYE
2. BACKGROUND DIABETIC RETINOPATHY – LEFT EYE
DISCUSSION: I explained to the patient that the left eye looks better today. I asked her to return here for a check when she returns in November. In the meantime, I asked her to see you back next month and because her intraocular pressure is a little bit high, I encouraged her to see an ophthalmologist every two or three months to make sure her pressure remains within a reasonable range.
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Chronic Pseudophakic Cystoid Macular Edema in a Patient with Diabetes514 views74-year-old woman has chronic cystoid macular edema in the left eye. She has had vision loss intermittently in that eye for 2 years, the right eye, unfortunately, lost vision from a central retinal vein occlusion in 6 years ago.
(0 votes)
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Chronic Pseudophakic Cystoid Macular Edema in a Patient with Diabetes521 views74-year-old woman has chronic cystoid macular edema in the left eye. She has had vision loss intermittently in that eye for 2 years, the right eye, unfortunately, lost vision from a central retinal vein occlusion in 6 years ago.
(1 votes)
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Chronic Pseudophakic Cystoid Macular Edema in a Patient with Diabetes426 views74-year-old woman has chronic cystoid macular edema in the left eye. She has had vision loss intermittently in that eye for 2 years, the right eye, unfortunately, lost vision from a central retinal vein occlusion in 6 years ago.
(0 votes)
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Chronic Pseudophakic Cystoid Macular Edema in a Patient with Diabetes429 views74-year-old woman has chronic cystoid macular edema in the left eye. She has had vision loss intermittently in that eye for 2 years, the right eye, unfortunately, lost vision from a central retinal vein occlusion in 6 years ago.
(0 votes)
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Chronic Pseudophakic Cystoid Macular Edema in a Patient with Diabetes367 views74-year-old woman has chronic cystoid macular edema in the left eye. She has had vision loss intermittently in that eye for 2 years, the right eye, unfortunately, lost vision from a central retinal vein occlusion in 6 years ago.
(0 votes)
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Chronic Pseudophakic Cystoid Macular Edema in a Patient with Diabetes414 views74-year-old woman has chronic cystoid macular edema in the left eye. She has had vision loss intermittently in that eye for 2 years, the right eye, unfortunately, lost vision from a central retinal vein occlusion in 6 years ago.
(0 votes)
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Chronic Pseudophakic Cystoid Macular Edema in a Patient with Diabetes370 views74-year-old woman has chronic cystoid macular edema in the left eye. She has had vision loss intermittently in that eye for 2 years, the right eye, unfortunately, lost vision from a central retinal vein occlusion in 6 years ago.
(0 votes)
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Chronic Pseudophakic Cystoid Macular Edema in a Patient with Diabetes449 views74-year-old woman has chronic cystoid macular edema in the left eye. She has had vision loss intermittently in that eye for 2 years, the right eye, unfortunately, lost vision from a central retinal vein occlusion in 6 years ago.
(0 votes)
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Chronic Pseudophakic Cystoid Macular Edema in a Patient with Diabetes418 views74-year-old woman has chronic cystoid macular edema in the left eye. She has had vision loss intermittently in that eye for 2 years, the right eye, unfortunately, lost vision from a central retinal vein occlusion in 6 years ago.
(0 votes)
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Chronic Pseudophakic Cystoid Macular Edema in a Patient with Diabetes404 views74-year-old woman has chronic cystoid macular edema in the left eye. She has had vision loss intermittently in that eye for 2 years, the right eye, unfortunately, lost vision from a central retinal vein occlusion in 6 years ago.
(0 votes)
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Chronic Pseudophakic Cystoid Macular Edema in a Patient with Diabetes409 views74-year-old woman has chronic cystoid macular edema in the left eye. She has had vision loss intermittently in that eye for 2 years, the right eye, unfortunately, lost vision from a central retinal vein occlusion in 6 years ago.
(0 votes)
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Chronic Pseudophakic Cystoid Macular Edema in a Patient with Diabetes408 views74-year-old woman has chronic cystoid macular edema in the left eye. She has had vision loss intermittently in that eye for 2 years, the right eye, unfortunately, lost vision from a central retinal vein occlusion in 6 years ago.
(0 votes)
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Chronic Pseudophakic Cystoid Macular Edema in a Patient with Diabetes394 views74-year-old woman has chronic cystoid macular edema in the left eye. She has had vision loss intermittently in that eye for 2 years, the right eye, unfortunately, lost vision from a central retinal vein occlusion in 6 years ago.
(0 votes)
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Chronic Pseudophakic Cystoid Macular Edema in a Patient with Diabetes502 views74-year-old woman has chronic cystoid macular edema in the left eye. She has had vision loss intermittently in that eye for 2 years, the right eye, unfortunately, lost vision from a central retinal vein occlusion in 6 years ago.
(0 votes)
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74-year-old woman has chronic cystoid macular edema in the left eye. She has had vision loss intermittently in that eye since March of 2006 (2 years ago). The right eye, unfortunately, lost vision from a central retinal vein occlusion in 2003. Her cataract surgery was done in the left eye in September of 2005. She is on Acular and Pred Forte in the left eye twice a day. Her vision in the left eye seems fine.
VISUAL ACUITY: OD: 20/400; OS: 20/40. IOP: OS: 13. The left eye has a posterior chamber intraocular lens is in good position.
EXTENDED OPHTHALMOSCOPY:
OS: Vertical C/D ratio is 0.3. There is 2+ cystoid macular edema with patchy retinal hemorrhages.
OCT SCAN: The OCT scan shows worsened cystoid macular edema with a central foveal thickness of 383 microns compared to the last visit when it was 301 microns.
FLUORESCEIN ANGIOGRAM: FA shows a cystoid macular edema with late leakage into the fovea. There are rare microaneurysms.
IMPRESSION:
1. BACKGROUND DIABETIC RETINOPATHY – LEFT EYE
2. CHRONIC PSEUDOPHAKIC CYSTOID MACULAR EDEMA – LEFT EEY
DISCUSSION: I explained to the patient that she does unfortunately have chronic macular edema associated with the cataract surgery a few years ago. I suggested we give her a posterior sub-Tenon Kenalog shot. She tolerated that fine before and did not have the problem with intraocular pressure rise. I injected the eye today without any difficulty. She is to return for a check in six weeks, sooner should she notice any problem. She will see you back periodically.
3 month follow-up:
March 11, 2008. This pleasant 74-year-old woman has macular edema in the left eye. She is also diabetic and pseudophakic. She had a good response to posterior sub-Tenon Kenalog shot in March of 2006. I re-treated her in January of 2008 and her vision has improved some.
VISUAL ACUITY: OS 20/30. IOP: OS 22. The posterior chamber intraocular lens is in good position.
EXTENDED OPHTHALMOSCOPY:
OS: Vertical C/D ratio is 0.3. There is 2+ retinal hemorrhages. The fovea looks to have flattened out some.
OCT SCAN: The OCT scan confirms a decreased macular edema. The central foveal thickness is 264 microns, which is better than last visit when it was 383 microns.
IMPRESSION:
1. RESOLVED CYSTOID MACULAR EDEMA – LEFT EYE
2. BACKGROUND DIABETIC RETINOPATHY – LEFT EYE
DISCUSSION: I explained to the patient that the left eye looks better today. I asked her to return here for a check when she returns in November. In the meantime, I asked her to see you back next month and because her intraocular pressure is a little bit high, I encouraged her to see an ophthalmologist every two or three months to make sure her pressure remains within a reasonable range.
