Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0851184 (thinning)
 11,252 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Cystoid macular edema (CME) is a classical complication of ocular inflammation. This syndrome was already described by Irvine in 1953 but the pathogenesis of this condition remains unclear. Cystoid macular edema can result either from a rupture of the inner or from the outer blood ocular barrier. Clinical CME that is responsible for a low visual acuity must be differentiated from angiographic CME that can be present even without any decrease in visual acuity. Fluid progressively accumulates into the outer plexiform layer of the retina and pools into cystic spaces. Fluid accumulation can now be better seen with optical coherence tomography (OCT). In chronic CME fluid accumulation is associated with thinning of the retina and fibrosis. At this stage irreversible lesions are present and CME does not respond to medical therapies. Inflammatory CME must be differentiated from CME resulting from irreversible vascular damage such as in diabetic CME or due to vein occlusions. Experimental research on cystoid macular edema has been hampered by the lack of animal model: most of laboratory animals have no macula, monkeys appear to be highly resistant to macular edema. Five major causes have been suspected to be at the origin of CME: (1) photic retinopathy, (2) trauma of ocular tissue, (3) secondary irritation of the ciliary body, (4) vitreous traction and (5) pharmaceutically induced CME. Clinical experience has shown that pseudophakic CME usually responds well to local therapy of steroids and non-steroidal antiinflammatory drugs (NSAIDs) and/or in association with systemic acetazolamide. Acetazolamide is increasing fluid resorption through the retinal pigment epithelium. Postoperative CME rarely needs additional posterior subtenon's injections to resolve. But in CME occurring secondary to uveitis additional posterior sub-Tenon's steroid injections or systemic steroids may be necessary to decrease the constant release of inflammatory mediators.
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PMID:The pathogenesis and clinical presentation of macular edema in inflammatory diseases. 1089 43

This report describes a patient who developed a corneal melt after the use of nepafenac, a nonsteroidal antiinflammatory drug. An 82-year-old woman with chronic cystoid macular edema after cataract extraction and intraocular lens implantation in the left eye, which was clinically controlled with a topical nonsteroidal antiinflammatory drug, was initially treated with diclofenac sodium 0.1% before being treated with nepafenac 0.1%. After 5 months of nepafenac use, the patient complained of pain, a foreign body sensation, and decreased vision in her left eye. The left eye showed a peripheral corneal ulcer with no stromal cell infiltration. The corneal ulcer was scraped and cultured to show epithelial cells and neutrophils with no growth of microorganisms. The nepafenac was discontinued, and a topical antibiotic and lubrication were used. After 2 months, the patient's visual acuity improved, and she had an intact epithelium and stable corneal thinning. To the authors' knowledge, this is the first case report of a corneal melt after the prolonged use of nepafenac to treat cystoid macular edema.
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PMID:Corneal melting after use of nepafenac in a patient with chronic cystoid macular edema after cataract surgery. 1832 52

Hyperbaric oxygen therapy is a primary or adjuvant therapeutic method used in treatment of various acute or chronic disorders. Currently, eye diseases are among the off-label use of hyperbaric oxygen. However, there is an increasing body of evidence showing its safety and efficacy in retinal artery occlusion, cystoid macular edema secondary to retinal vein occlusion, scleral thinning and necrosis faced after pterygium surgery, orbital rhino-cerebral mucormycosis, nonhealing corneal edema, and anterior segment ischemia. Its potential to treat some blinding disease has also been pointed out in recent studies. This article constitutes an up-to-date summary of knowledge and therapeutic use of hyperbaric oxygen, and aims to contribute understanding of current and potential use of hyperbaric oxygen therapy in ophthalmology.
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PMID:The use of hyperbaric oxygen therapy in ophthalmology. 1834 77