Inflammatory cystoid macular edema.
OBJECTIVE
The aim of this article is to update our current understanding and management of inflammatory cystoid macular edema.


RESULTS
Cystoid macular edema is a common cause of visual loss in uveitis, which occurs predominantly in older patients with chronic uveitis forms and might be heralded by subclinical changes on optic coherence tomography. Cystoid macular edema is emerging as a major cause of visual loss in HIV-infected patients with immune recovery uveitis. Elevated levels of proinflammatory cytokines and vascular endothelial growth factor were found in all types of cystoid macular edema. Treatment with anti-inflammatory and anti-vascular endothelial growth factor drugs is widely applied for all forms of cystoid macular edema and usually has a beneficial, but temporary effect. So far, there are no clear guidelines for the treatment of subclinical cystoid macular edema in uveitis. The effect of vitrectomy in inflammatory cystoid macular edema is not yet clear and might become more important in the future. Recent advances in management include intravitreal drug delivery systems of cystoid macular edema-modifying drugs.


CONCLUSIONS
This review summarizes current thoughts on inflammatory cystoid macular edema focusing on the new, clinically relevant findings. Upcoming data on aqueous constituents in cystoid macular edema and imaging with the new generation of optic coherence tomography offer the hope that a better treatment strategy will soon be established.
Rothova
Aniki
A
Department of Ophthalmology, University Medical Center, Utrecht, The Netherlands. a.rothova@umcutrecht.nl
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D006801:Humans; D007372:Interferons / Q000627:therapeutic use; D008269:Macular Edema / Q000150:complications / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D013508:Ophthalmologic Surgical Procedures; D013004:Somatostatin / Q000031:analogs & derivatives; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors; D014605:Uveitis / Q000150:complications*; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014786:Vision Disorders / Q000209:etiology
D000893:Anti-Inflammatory Agents; D014409:Tumor Necrosis Factor-alpha; D042461:Vascular Endothelial Growth Factor A; D013004:Somatostatin; D007372:Interferons