WordNet

in or relating to the retina of the eye; "retinal cells"
swelling from excessive accumulation of watery fluid in cells, tissues, or serous cavities (同)oedema, hydrops, dropsy
the innermost light-sensitive membrane covering the back wall of the eyeball; it is continuous with the optic nerve

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浮腫(ふしゅ),水腫
(目の)網膜

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/10/28 06:50:55」(JST)

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Diabetic macular edema, with hard exudates surrounding the blood vessels.

Macular edema occurs when fluid and protein deposits collect on or under the macula of the eye (a yellow central area of the retina) and causes it to thicken and swell (edema). The swelling may distort a person's central vision, as the macula is near the center of the retina at the back of the eyeball. This area holds tightly packed cones that provide sharp, clear central vision to enable a person to see detail, form, and color that is directly in the direction of gaze.

Macular edema sometimes appears for a few days or weeks after cataract surgery, but most such cases can be successfully treated with NSAID or cortisone eye drops.

Classification

Cystoid macular edema (CME) involves fluid accumulation in the outer plexiform layer secondary to abnormal perifoveal retinal capillary permeability. The edema is termed "cystoid" as it appears cystic; however, lacking an epithelial coating, it is not truly cystic. The etiology for CME can be remembered with the mnemonic "DEPRIVEN" (Diabetes, Epinepherine, Pars planitis, Retinitis pigmentosa, Irvine-Gass Syndrome, Venous occlusion, E2-Prostaglandin analogues, Nicotinic acid/Niacin).

Diabetic macular edema (DME) is similarly caused by leaking macular capillaries. DME is the most common cause of visual loss in both proliferative, and non-proliferative diabetic retinopathy.

Approved treatments

In 2010 the US FDA approved the use of Lucentis injections for macular edema.^[1]

Iluvien, a sustained release intravitreal implant developed by Alimera Sciences, has been approved in Austria, Portugal and the U.K. for the treatment of vision impairment associated with chronic diabetic macular edema (DME) considered insufficiently responsive to available therapies. Additional EU country approvals are anticipated.^[2]

On July 29, 2014, EYLEA (aflibercept), an intravitreal injection produced by Regeneron Pharmaceuticals Inc., was approved to treat DME in the United States. ^[3]

Clinical trials

In 2005, steroids were investigated for macular edema due to retinal blood vessel blockage such as CRVO and BRVO.^[4]

Additional research

A 2014 Cochrane Systematic Review studied the effectiveness of two anti-VEGF treatments, ranibizumab and pegaptanib, on patients suffering from macular edema caused by CRVO.^[5] Participants on both treatment groups showed a reduction in macular edema symptoms over six months.^[5]

References

^ "GEN | News Highlights: FDA Green-Lights Genentechâ€™s Lucentis for Macular Edema following Retinal Vein Occlusion". Genengnews.com. Retrieved 2012-12-15.
^ "Iluvien gains marketing authorization in Portugal for chronic DME". OSN SuperSite, June 7, 2012. Retrieved June 20, 2012
^ http://files.shareholder.com/downloads/REGN/3361382769x0x772028/698a12f7-a8dc-4f89-b9e2-f8134ae6f3de/REGN_News_2014_7_29_General_Releases.pdf
^ "Steroid Injections vs. Standard Treatment for Macular Edema Due to Retinal Blood Vessel Blockage - Full Text View". ClinicalTrials.gov. Retrieved 2012-12-15.
^ ^a ^b Braithwaite T, Nanji AA, Greenberg PB (2010). "Anti-vascular endothelial growth factor for macular edema secondary to central retinal vein occlusion". Cochrane Database Syst Rev 10: CD007325. doi:10.1002/14651858.CD007325.pub3. PMID 20927757.

UpToDate Contents

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1. 糖尿病性網膜症：分類および臨床的特徴 diabetic retinopathy classification and clinical features
2. 救急外来における眼部損傷の概要 overview of eye injuries in the emergency department
3. 成人における浮腫の臨床症状および診断 clinical manifestations and diagnosis of edema in adults
4. 成人における浮腫に対する治療の一般原則 general principles of the treatment of edema in adults
5. 急性持続性視力喪失が認められた成人に対するアプローチ approach to the adult with acute persistent visual loss

English Journal

Hydrocephalus and Hypothalamic Involvement in Pediatric Patients with Craniopharyngioma or Cysts of Rathke's Pouch: Impact on Long-term Prognosis.

Daubenbüchel AM1, Hoffmann A2, Gebhardt U3, Warmuth-Metz M4, Sterkenburg AS5, Müller HL6.
European journal of endocrinology / European Federation of Endocrine Societies.Eur J Endocrinol.2015 Feb 3. pii: EJE-14-1029. [Epub ahead of print]
Objective: Pediatric patients with sellar masses such as craniopharyngioma (CP) or cyst of Rathke's pouch (CRP) frequently suffer disease- and treatment-related sequelae. We analyzed the impact and prognostic relevance of initial hydrocephalus (HY) and hypothalamic involvement (HI) on long-term surv
PMID 25650403

TYPE 3 NEOVASCULARIZATION: Evolution, Association With Pigment Epithelial Detachment, and Treatment Response as Revealed by Spectral Domain Optical Coherence Tomography.

Nagiel A1, Sarraf D, Sadda SR, Spaide RF, Jung JJ, Bhavsar KV, Ameri H, Querques G, Freund KB.
Retina (Philadelphia, Pa.).Retina.2015 Feb 2. [Epub ahead of print]
PURPOSE:: To demonstrate the evolution and treatment response of Type 3 neovascularization using spectral domain optical coherence tomography.METHODS:: We retrospectively analyzed 40 eyes treated with intravitreal anti-vascular endothelial growth factor therapy for Type 3 neovascularization over a v
PMID 25650713

Ranibizumab for Branch Retinal Vein Occlusion Associated Macular Edema Study (RABAMES): six-month results of a prospective randomized clinical trial.

Pielen A1, Mirshahi A, Feltgen N, Lorenz K, Korb C, Junker B, Schaefer C, Zwiener I, Hattenbach LO; RABAMES Study Group.
Acta ophthalmologica.Acta Ophthalmol.2015 Feb;93(1):e29-37. doi: 10.1111/aos.12488. Epub 2014 Jul 8.
PURPOSE: To compare standard-of-care grid laser photocoagulation versus intravitreal ranibizumab (IVR) versus a combination of both in the treatment of chronic (>3 months) macular oedema secondary to branch retinal vein occlusion.METHODS: Prospective, randomized, multicentre clinical trial. Thir
PMID 25042729

Japanese Journal

浮腫性疾患 : RVO,DR:胞腔の構造,浮腫とSRDの関係 (特集 SD-OCT網膜像読影のポイント)

三木克朗,？橋寛二
眼科 54(11), 1599-1606, 2012-10
NAID 40019471861

臨床報告網膜静脈閉塞症黄斑浮腫眼のベバシズマブ硝子体注射後網膜前膜

有泉俊人,花田斉久,北村一義
眼科 54(6), 791-796, 2012-06
NAID 40019357851

Prospective multicenter study of visual outcomes following three different treatments for macular edema associated with branch retinal vein occlusion : a study by the Japanese BRVO study group

HARINO Seiyo,BESSHO Kenichiro,KIDA Teruyo
Japanese journal of ophthalmology 56(3), 250-261, 2012-05-01
NAID 10030626920

Related Pictures

Waldenstrom Macroglobulinema-Associated Retinopathy Laser Treatment for Diabetic Macular Edema - Retina Specialist | Fairfax, Virginia Cataract Complications: The Retinal Perspective Cystoid Macular Edema | Retina Vitreous Associates Medical Group Role of Disorganization of Retinal Inner Layers as an Optical Coherence Tomography Diabetic macular edema-Current treatment Modalities Spectral-Domain Optical Coherence Tomography Angiography of Central Retinal Artery Macular Edema - Retina Institute of Hawaii

★リンクテーブル★

リンク元	「網膜浮腫」「optic papillitis」
関連記事	「retinal」

「網膜浮腫」

Macular edema
	A 61-year-old man with medical history of type 2 diabetes that presents a macular edema, evidenced by an OCT (the edema marked with arrows). The central image is a 3D reconstruction of the retinal thickness (the edema is coloured in red).
Classification and external resources
Specialty	ophthalmology
ICD-10	H35.8
ICD-9-CM	362.01, 362.53