Topical NSAIDs, intravitreal dexamethasone and peribulbar triamcinolone for pseudophakic macular edema

Abstract Background The purpose of this study is to assess the effectiveness of topical nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids (intravitreal dexamethasone and peribulbar triamcinolone) in treating pseudophakic macular edema (PME). Methods Retrospective study of 33 eyes. Va...

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Autores principales:	Javier Obis, Luis Arias, Daniel Lorenzo, Noel Padron-Perez, Pere Garcia-Bru, Estefania Cobos, Rahul Morwani, Jose Caminal
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Pseudophakic macular edema / Irvine Gass syndrome Topical NSAIDs Intravitreal dexamethasone Peribulbar triamcinolone Central retinal thickness Central choroidal thickness Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/9b0b0f0784304ceb901c1272c5d82cb7
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spelling	oai:doaj.org-article:9b0b0f0784304ceb901c1272c5d82cb72021-11-08T11:19:30ZTopical NSAIDs, intravitreal dexamethasone and peribulbar triamcinolone for pseudophakic macular edema10.1186/s12886-021-02132-w1471-2415https://doaj.org/article/9b0b0f0784304ceb901c1272c5d82cb72021-11-01T00:00:00Zhttps://doi.org/10.1186/s12886-021-02132-whttps://doaj.org/toc/1471-2415Abstract Background The purpose of this study is to assess the effectiveness of topical nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids (intravitreal dexamethasone and peribulbar triamcinolone) in treating pseudophakic macular edema (PME). Methods Retrospective study of 33 eyes. Variables included best corrected visual acuity (BCVA; logMAR scale) and central retinal thickness (CRT) and central choroidal thickness (CCT) assessed with swept-source OCT. All patients were initially prescribed topical NSAIDs and reevaluated after 2 months. If improvement in BCVA or CRT was noted, topical NSAIDs were continued until resolution. If no improvement was observed at 2 months or subsequent visits, intravitreal dexamethasone implant was performed. Patients who refused intravitreal treatment were offered peribulbar triamcinolone. Results After treatment with topical NSAIDs for a median of 2 months, BCVA increased significantly from 0.5 to 0.3 while CRT decreased significantly from 435 to 316 μm. PME resolved in 19 of the 33 eyes (57.6%). Of the 14 recalcitrant cases, 13 were treated with corticosteroids. Of these 13 cases, 9 (69.2%) resolved. BCVA increased non-significantly from 0.7 to 0.4. CRT and CCT decreased significantly from 492 to 317 μm and from 204 to 182 μm respectively. Conclusions The overall success rate of the treatment algorithm was greater than 80%, a remarkable finding considering that no randomized study has yet been conducted to determine the optimal therapeutic protocol for PME. This is the first study to evaluate choroidal thickness in PME using SS-OCT, which could play a key role in its pathophysiology and provide useful information to improve the management of PME.Javier ObisLuis AriasDaniel LorenzoNoel Padron-PerezPere Garcia-BruEstefania CobosRahul MorwaniJose CaminalBMCarticlePseudophakic macular edema / Irvine Gass syndromeTopical NSAIDsIntravitreal dexamethasonePeribulbar triamcinoloneCentral retinal thicknessCentral choroidal thicknessOphthalmologyRE1-994ENBMC Ophthalmology, Vol 21, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Pseudophakic macular edema / Irvine Gass syndrome Topical NSAIDs Intravitreal dexamethasone Peribulbar triamcinolone Central retinal thickness Central choroidal thickness Ophthalmology RE1-994
spellingShingle	Pseudophakic macular edema / Irvine Gass syndrome Topical NSAIDs Intravitreal dexamethasone Peribulbar triamcinolone Central retinal thickness Central choroidal thickness Ophthalmology RE1-994 Javier Obis Luis Arias Daniel Lorenzo Noel Padron-Perez Pere Garcia-Bru Estefania Cobos Rahul Morwani Jose Caminal Topical NSAIDs, intravitreal dexamethasone and peribulbar triamcinolone for pseudophakic macular edema
description	Abstract Background The purpose of this study is to assess the effectiveness of topical nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids (intravitreal dexamethasone and peribulbar triamcinolone) in treating pseudophakic macular edema (PME). Methods Retrospective study of 33 eyes. Variables included best corrected visual acuity (BCVA; logMAR scale) and central retinal thickness (CRT) and central choroidal thickness (CCT) assessed with swept-source OCT. All patients were initially prescribed topical NSAIDs and reevaluated after 2 months. If improvement in BCVA or CRT was noted, topical NSAIDs were continued until resolution. If no improvement was observed at 2 months or subsequent visits, intravitreal dexamethasone implant was performed. Patients who refused intravitreal treatment were offered peribulbar triamcinolone. Results After treatment with topical NSAIDs for a median of 2 months, BCVA increased significantly from 0.5 to 0.3 while CRT decreased significantly from 435 to 316 μm. PME resolved in 19 of the 33 eyes (57.6%). Of the 14 recalcitrant cases, 13 were treated with corticosteroids. Of these 13 cases, 9 (69.2%) resolved. BCVA increased non-significantly from 0.7 to 0.4. CRT and CCT decreased significantly from 492 to 317 μm and from 204 to 182 μm respectively. Conclusions The overall success rate of the treatment algorithm was greater than 80%, a remarkable finding considering that no randomized study has yet been conducted to determine the optimal therapeutic protocol for PME. This is the first study to evaluate choroidal thickness in PME using SS-OCT, which could play a key role in its pathophysiology and provide useful information to improve the management of PME.
format	article
author	Javier Obis Luis Arias Daniel Lorenzo Noel Padron-Perez Pere Garcia-Bru Estefania Cobos Rahul Morwani Jose Caminal
author_facet	Javier Obis Luis Arias Daniel Lorenzo Noel Padron-Perez Pere Garcia-Bru Estefania Cobos Rahul Morwani Jose Caminal
author_sort	Javier Obis
title	Topical NSAIDs, intravitreal dexamethasone and peribulbar triamcinolone for pseudophakic macular edema
title_short	Topical NSAIDs, intravitreal dexamethasone and peribulbar triamcinolone for pseudophakic macular edema
title_full	Topical NSAIDs, intravitreal dexamethasone and peribulbar triamcinolone for pseudophakic macular edema
title_fullStr	Topical NSAIDs, intravitreal dexamethasone and peribulbar triamcinolone for pseudophakic macular edema
title_full_unstemmed	Topical NSAIDs, intravitreal dexamethasone and peribulbar triamcinolone for pseudophakic macular edema
title_sort	topical nsaids, intravitreal dexamethasone and peribulbar triamcinolone for pseudophakic macular edema
publisher	BMC
publishDate	2021
url	https://doaj.org/article/9b0b0f0784304ceb901c1272c5d82cb7
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Topical NSAIDs, intravitreal dexamethasone and peribulbar triamcinolone for pseudophakic macular edema

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