WordNet

swelling from excessive accumulation of watery fluid in cells, tissues, or serous cavities (同)oedema, hydrops, dropsy
a small yellowish central area of the retina that is rich in cones and that mediates clear detailed vision (同)macula_lutea, macular_area, yellow_spot

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浮腫(ふしゅ),水腫

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/07/17 12:22:56」(JST)

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

Until recently there were no good treatments for macular edema caused by central retinal vein occlusion (CRVO). Laser photocoagulation has been used for macular edema caused by branch retinal vein occlusion (BRVO).^[1]

Classification[edit]

Cystoid macular edema (CME) involves fluid accumulation in the outer plexiform layer secondary to abnormal perifoveal retinal capilary 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, Nicotinic acid and 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[edit]

In 2010 the US FDA approved the use of Lucentis injections for macular edema.^[2]

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.^[3]

Clinical trials[edit]

In 2005, steroids were investigated for macular edema due to retinal blood vessel blockage such as CRVO and BRVO.^[1]

References[edit]

^ ^a ^b "Steroid Injections vs. Standard Treatment for Macular Edema Due to Retinal Blood Vessel Blockage - Full Text View". ClinicalTrials.gov. Retrieved 2012-12-15.
^ "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

UpToDate Contents

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1. 原発性眼障害関連の網膜血管炎 retinal vasculitis associated with primary ocular disorders
2. 成人における白内障 cataract in adults
3. ブドウ膜炎：治療 uveitis treatment
4. 全身性疾患および感染に関連した網膜血管炎 retinal vasculitis associated with systemic disorders and infections
5. 網膜色素変性症：治療 retinitis pigmentosa treatment

English Journal

Possible Short-term Changes of Aqueous Inflammatory Cytokines After Intravitreal Bevacizumab for Diabetic Macular Edema.

Lee WJ, Cho HY.SourceGyeonggi-do, South Korea.
American journal of ophthalmology.Am J Ophthalmol.2012 Feb;153(2):387-8.
PMID 22264958

Global Prevalence and Major Risk Factors of Diabetic Retinopathy.

Yau JW, Rogers SL, Kawasaki R, Lamoureux EL, Kowalski JW, Bek T, Chen SJ, Dekker JM, Fletcher A, Grauslund J, Haffner S, Hamman RF, Ikram MK, Kayama T, Klein BE, Klein R, Krishnaiah S, Mayurasakorn K, O'Hare JP, Orchard TJ, Porta M, Rema M, Roy MS, Sharma T, Shaw J, Taylor H, Tielsch JM, Varma R, Wang JJ, Wang N, West S, Xu L, Yasuda M, Zhang X, Mitchell P, Wong TY; on behalf of the Meta-Analysis for Eye Disease (META-EYE) Study Group.SourceCentre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia.
Diabetes care.Diabetes Care.2012 Feb 1. [Epub ahead of print]
OBJECTIVETo examine the global prevalence and major risk factors for diabetic retinopathy (DR) and vision-threatening diabetic retinopathy (VTDR) among people with diabetes.RESEARCH DESIGN AND METHODSA pooled analysis using individual participant data from population-based studies around the world w
PMID 22301125

Ketorolac therapy for the prevention of acute pseudophakic cystoid macular edema: a systematic review.

Yilmaz T, Cordero-Coma M, Gallagher MJ.SourceDepartment of Ophthalmology, Stony Brook, NY, USA.
Eye (London, England).Eye (Lond).2012 Feb;26(2):252-8. doi: 10.1038/eye.2011.296. Epub 2011 Nov 18.
To assess the effectiveness of ketorolac vs control for prevention of acute pseudophakic cystoid macular edema (CME). The following databases were searched: Medline (1950-June 11, 2011), The Cochrane Library (Issue 2, 2011), and the TRIP Database (up to 11 June 2011), using no language or other limi
PMID 22094296

Japanese Journal

臨床報告パクリタキセル投与中に黄斑部胞様変化をきたした1例

高橋伸通,小國務,堀暢英
眼科 54(12), 1819-1824, 2012-11
NAID 40019496323

トラボプロスト点眼により嚢胞様黄斑浮腫を生じた1例

平原修一郎,野崎実穂,久保田綾恵,小椋祐一郎
あたらしい眼科 = Journal of the eye 29(5), 687-690, 2012-05-30
NAID 10030624921

若年者の虚血型網膜中心静脈閉塞症に対する放射状視神経乳頭切開術の長期経過

東寛子/山本香織/堀貞夫
東京女子医科大学雑誌 82(E1), 273-279, 2012-01-31
… 初診時右眼の視力は0.2 (矯正不能)で、右眼には全周網膜出血、網膜静脈拡張・蛇行、視神経乳頭浮腫、黄斑部には嚢胞様黄斑浮腫 (cystoid macular edema: CME) ・漿液性網膜剥離を認めた。 …
NAID 110008767991