Cystoid macular oedema (CMO)

Definition: Thickening of macula from breakdown of blood retinal barrier leading to accumulation of intraretinal fluid at the junction of inner nuclear layer and outer plexiform layer.


Causes:

  1. Metabolic – DR, radiation
  2. Ischaemic – RVO, DR, HTN, vasculitis, collagen dis
  3. Mechanical – VMT, ERM
  4. Inflammation – uveitis, post-op
  5. Hydrostatic – hypotony, venous occlusion
  6. Miscellaneous – macroaneurysm, telangiectasia, CNV, choroidal haemangioma, drugs (epinephrine, betaxolol, latanoprost), RP
  7. CMO like condition – XLR, nicotinic acid, OD pit, Goldmann Favre

Symptoms: loss of vision with metamorphopsia.

Investigations: OCT macula; FFA


Treatment:

  1. Observe – most cases resolve especially uncomplicated cataract surgery within 6 mths.
  2. Diamox – for RP
  3. Topical NSAIDs – for inflammatory causes. (also to consider as prophylaxis pre op for high risk cases)
  4. Topical, periocular, intravitreal or oral/IV corticosteroids – for inflammatory causes.
  5. IVT anti-VEGF – for ischaemic causes.
  6. Immunosuppressive drugs – for inflammatory causes.
  7. Grid Laser – for ischaemic causes.
  8. PPV – for mechanical causes.

Location Birmingham Midlands Eye Centre 76 Dudley Road Birmingham B18 7QH UK Phone 0121 554 3801 Hours Mr Ch'ng | Vitreoretinal Clinic Sessions: Monday: 8.30am - 12.30pm Wednesday (alternate): 8.30am - 5.00pm Thursday: 8.30am - 12.30pm Friday: 8.30am - 12.30pm | Vitreoretinal Theatre Sessions: Wednesday (alternate): 8.30am - 5.00pm & Friday (emergency cases): 1.30pm - 5.00pm | Eye Casualty Session: Monday 1.00pm - 4.30pm |
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