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PubMed1985

Breast edema in patients treated conservatively for stage I and II breast cancer.

Breast edema was evaluated in 45 patients with Stage I or II breast cancer (including two with simultaneous, bilateral disease), who were treated by breast-preserving treatment approaches. Multiple variable statistical analysis revealed that bra cup size was the only factor significantly related to the appearance of breast edema. Breast edema occurred in 3 of 20 breasts (15%) with bra cup size A or B, as compared to 13 of 27 breasts (48%) with bra cup size C, D or DD(p less than 0.03). Breast edema was more likely to occur in patients who underwent full axillary dissection as compared to those who underwent axillary sampling or no axillary surgery. This observation, however, was not statistically significant. Neither the radiation therapy parameters nor the use of adjuvant chemotherapy were found to be related to the development of breast edema. Breast edema appears to be a transient phenomenon observed most frequently in the first year after the end of irradiation. It was observed much less frequently in those patients evaluated over 1 year following the end of radiation therapy.

Adult↗
PubMed2004

Lipid-lowering drug atorvastatin as an adjunct in the management of diabetic macular edema.

PURPOSE: To determine the efficacy of the lipid-lowering drug atorvastatin in reducing retinal hard exudates and subfoveal lipid migration after focal/grid laser photocoagulation in clinically significant macular edema in patients with diabetes with elevated serum lipids. DESIGN: Randomized case trial. METHODS: Thirty patients with type 2 diabetes with clinically significant macular edema, dyslipidemia, and hard exudates of grade 4 and above were assessed in an institutional setting. All patients were subjected to strict metabolic control within 4 to 6 weeks of enrollment. In addition, 15 patients in group A received atorvastatin, a 3-hydroxy-3-methylglutaryl coenzyme A inhibitor; 15 members of group B did not receive any lipid-lowering therapy. All received laser photocoagulation after a metabolic control period and were followed up for a minimum of 18 weeks. The outcome measures were reduction in hard exudates, subfoveal lipid migration, status of macular edema, and visual acuity. RESULTS: The study included 21 men and nine women with noninsulin-dependent diabetes mellitus who could achieve good metabolic control within 4 to 6 weeks of inclusion in the study. All patients had elevated serum lipids at baseline. Ten (66.6%) of 15 patients in treatment group A and two (13.3%) of 15 patients in control group B showed reduction in hard exudates (P =.007). None of the patients in group A and five (33.3%) of 15 in group B showed subfoveal lipid migration after laser photocoagulation (P =.04). Regression of macular edema was seen in nine eyes in group A and five in group B (P =.27). None of the eyes in group A and three eyes in group B showed worsening of visual acuity (P =.22). CONCLUSION: Oral atorvastatin therapy in patients with type 2 diabetes with dyslipidemia reduces the severity of hard exudates and subfoveal lipid migration in clinically significant macular edema and could be an important adjunct in the management of clinically significant macular edema.

Administration, Oral↗
PubMed2005

Pathogenesis of macular edema with branch retinal vein occlusion and intraocular levels of vascular endothelial growth factor and interleukin-6.

PURPOSE: To determine whether correlations between vascular endothelial growth factor (VEGF) or interleukin-6 (IL-6) contribute to the pathogenesis of macular edema in eyes of patients with branch retinal vein occlusion (BRVO). DESIGN: Retrospective case-control study. METHODS: Nineteen patients with macular edema with BRVO and seven patients with non-ischemic ocular disease (control group) were studied. The degree of retinal ischemia was evaluated in terms of the area of capillary non-perfusion, and the severity of macular edema was examined by optical coherence tomography. Aqueous humor samples were obtained at the time of combined vitrectomy and cataract surgery, and VEGF and IL-6 levels in aqueous humor and plasma were determined by enzyme-linked immunosorbent assay. RESULTS: Aqueous levels of VEGF (351 +/- 273 pg/ml) and IL-6 (7.10 +/- 6.51 pg/ml) were significantly elevated in patients with BRVO compared with the control patients (119 +/- 38.7 pg/ml and 2.27 +/- 1.11 pg/ml, respectively) (P = .0017 and P = .0052, respectively). Aqueous level of VEGF was significantly correlated with that of IL-6 (P = .0396), and aqueous levels of VEGF and IL-6 were correlated with the size of the BRVO non-perfused area (P < .0001 and P = .0331, respectively). Aqueous level of VEGF was correlated with the severity of macular edema (P = .0306). CONCLUSIONS: VEGF and IL-6 may be involved in the pathogenesis of macular edema with BRVO. The increase in these cytokines might be used as a unique index of BRVO, through which we can determine the severity of the ischemic condition as being in a quiescent state or an exacerbation of macular edema.

Aged↗
PubMed2005

Regression of serous macular detachment after intravitreal triamcinolone acetonide in patients with diabetic macular edema.

PURPOSE: To evaluate the effect of intravitreal triamcinolone acetonide on serous macular detachment in eyes with diabetic macular edema. DESIGN: Interventional case series. METHODS: The study population comprised twenty eyes of 20 patients with diabetic macular edema (12 men, eight women), aged 48 to 76 years. The eligibility criteria for this study included clinically detectable macular edema in which the presence of serous macular detachment was documented by optical coherence tomography. After intravitreal injection of 0.1 ml (4 mg) triamcinolone acetonide, visual and anatomic responses were observed. RESULTS: In all eyes, after an injection of triamcinolone acetonide, macular edema and serous macular detachment regressed. At 3 and 6 months, macular edema and serous macular detachment had recurred in eight (40%) and nine eyes (45%), respectively. Patients with recurrence were re-treated. No eyes lost vision at 1 month, and all eyes showed improvement. At 3 months, no eyes had lost vision from baseline, and 17 eyes (85%) showed improvement. At 6 months, again no eyes had lost vision from baseline, and 16 eyes (80%) maintained improved visual acuity. CONCLUSION: Intravitreal triamcinolone acetonide is an effective treatment for serous macular detachment in patients with diabetic macular edema.

Aged↗
PubMed2004

MRI-CT fusion to assess postbrachytherapy prostate volume and the effects of prolonged edema on dosimetry following transperineal interstitial permanent prostate brachytherapy.

PURPOSE: Quality assurance through postplan assessment is an integral part of permanent seed prostate implants. The use of MRI-CT fusion for 1-month postimplant dosimetry permits accurate assessment of prostate volume without seed induced artifact and uncertainties of prostate contour inherent to CT assessments. Routine use of MRI-CT fusion reveals significant prostate edema may persist several weeks. This study evaluates the effect of edema, and its subsequent resolution, on dosimetry. METHODS AND MATERIALS: From May 2001 to June 2003, 241 men were treated with (125)I seed implants based on a transrectal ultrasound (TRUS) preplan. Quality assessment was performed at 1 month by CT-MRI fusion using VariSeed software. Over this 24-month period, 29 patients (12%) with residual edema at 1 month (12-60% >TRUS plan volume), had repeat CT-MRI fusion at 2-4 months to reassess volume and dosimetry. Eleven of the 29 had received prior androgen ablation to shrink the prostate preimplant. RESULTS: For the entire group (n = 241), mean preimplant prostate volume was 33.7 cc and median postplan dosimetric parameters were: V100, 92.2%; D90, 153 Gy; and V150, 53%. For the 29 patients with prolonged edema, mean preimplant volume was 34.8 cc and 1-month volume was 46.1 cc (p <0.001). Mean volume reduction between 1 and 2 months was 13%. The decrease in prostate volume had a significant effect on dosimetry with median increase between 1 month and 2 months in calculated V100 of 9.5%, V150 22.6%, V200 30.1%, and D90 11.5%. CONCLUSIONS: Significant residual edema is seen 1-month postimplant in 12% of prostates and may have a profound effect on dosimetry. Further study is underway to characterize the time course of resolution of the edema, and to perform integral dosimetry based on the changing volume.

Brachytherapy↗
PubMed2004

Vascular endothelial growth factor serum level is strongly enhanced after burn injury and correlated with local and general tissue edema.

BACKGROUND: Burn associated local and general tissue edema is induced by local cell destruction and capillary leak syndrome. Vascular endothelial growth factor (VEGF) strongly enhances vascular permeability as well as angiogenesis. The principal aim of this study was to investigate the systemic release of VEGF and its kinetics after severe burn injury in humans. METHODS: Thirty-six burn patients and 42 healthy volunteers were enrolled in this study. Circulating VEGF serum levels were measured by enzyme-linked immunosorbent assay at days 1, 3, 7, 14, 21, 28 and 35. Burn surface, tissue edema, complications and outcome were evaluated. RESULTS: VEGF serum levels were significantly increased after burn injuries immediately after injury until wound closure. VEGF levels reached their maximum at day 14 and were 22-fold increased compared to VEGF levels of healthy controls. After wound closure VEGF levels normalized. Local and general tissue edema disappeared after VEGF serum level normalization. CONCLUSIONS: VEGF serum levels are immediately enhanced after burn trauma until wound closure. At the same time, a local and general tissue edema was detected. We may speculate, that specific blockers of VEGF may have beneficial effects on edema and edema-related complications in severe burn patients.

Adolescent↗
PubMed2006

Contribution of TNFalpha, IL-1beta and CINC-1 for articular incapacitation, edema and cell migration in a model of LPS-induced reactive arthritis.

The protective effect of anti-CINC-1, -TNFalpha and -IL-1beta antisera on articular inflammatory incapacitation, articular diameter and synovial fluid cell content, which are correlated to nociception, edema and cell migration, respectively, were evaluated in a rat model of LPS-induced reactive arthritis. In this model, Escherichia coli lipopolysaccharide (LPS; 30 ng) was injected in a knee-joint previously primed with carrageenan (300 microg). Articular incapacitation was evaluated hourly by the automated registering of the knee-joint function during animal walking, and the knee-joint edema was evaluated by measuring the articular diameter increase. After 6 h, the animals were euthanized for collecting synovial fluid for the evaluation of cell migration. LPS produced dose-dependent incapacitation and edema. Anti-TNFalpha, -IL-1beta, and -CINC-1 antisera (20 and 40 microl) were used as pretreatment into knee-joint before LPS injection. At higher dose, Anti-TNFalpha and anti-CINC-1 were able to inhibit incapacitation, articular edema and mononuclear (MON) migration. Anti-IL1beta did not affect incapacitation at any dose, although inhibited edema and cell migration. Surprisingly, the higher dose of anti-IL1beta antisera did not inhibit cell migration, although inhibited articular edema. These findings corroborate the role TNFalpha has in different forms of arthritis, but points out the idea that CINC-1 (the homologue for human IL-8) may constitute a promising target for reactive arthritis management. Indeed, the potent antiedematogenic effect, and principally the anti-migration effect of anti-CINC-1, raises the possibility of a better control of disease progression than with anti-IL-1beta therapies.

Animals↗
PubMed2006

Thiazolidinediones and the risk of edema: a meta-analysis.

The use of thiazolidinediones (TZDs) in the management of type 2 diabetes mellitus (T2DM) has been associated with an increased risk of peripheral edema. A meta-analysis was performed to assess the overall risk for developing edema secondary to TZD. A systematic literature search was conducted using five electronic databases. All prospective, randomized, either placebo-controlled or comparative studies reporting the incidence of edema with TZD therapy were included. Odds ratios were generated by pooling estimates across the studies. The analysis included 26 studies consisting of 15,332 patients with T2DM. The pooled odds ratio for TZD induced edema was 2.26 (95% CI: 2.02-2.53). The results yielded a higher risk for developing edema with rosiglitazone (3.75 [2.70-5.20]) compared to pioglitazone (2.42 [1.90-3.08]). Concordant results persisted with calculations of the adjusted indirect estimate. This meta-analysis demonstrates at least a two-fold increase in the risk for developing edema with a TZD agent. The risk appears to be greater with rosiglitazone than with pioglitazone. Further studies are needed to explore this difference.

Clinical Trials as Topic↗
PubMed2006

Daily variability in dyspnea, edema and body weight in heart failure patients.

BACKGROUND: Heart failure (HF) and heart failure exacerbations are associated with distressing physical signs and symptoms that include dyspnea, peripheral edema and weight gain. There are no prior investigations that describe the daily fluctuations of these. PURPOSE: The purpose of this investigation was to characterize daily dyspnea, edema and body weight in patients with HF for 1 month. METHODS: This analysis used a descriptive correlational design. Data were collected daily for 30 days from a cohort of heart failure subjects (n=48). Daily mean values and associations between self-reported dyspnea, edema and body weight were determined. RESULTS: The sample included 48 participants with a mean age of 48+/-15 years. Slightly more than half were male (54%) and a majority were married (54%). On average, subjects with HF reported moderate daily levels of self-reported dyspnea and perceived edema. The average daily association between self-reported dyspnea and edema was a positive, significant relationship (p<0.001). There were fewer significant positive associations between self-reported dyspnea and body weight and self-reported edema and body weight. CONCLUSIONS: In this cohort, heart failure patients were able to monitor symptoms daily, detect fluctuations and may be able to modify self-care activities and therapeutic regimen based on these ratings.

Body Weight↗
PubMed2005

Noninflammatory flap edema after laser in situ keratomileusis associated with asymmetrical preoperative corneal pachymetry.

PURPOSE: To report persistent unilateral flap edema following laser in situ keratomileusis (LASIK) in patients with asymmetrical central corneal thickness. SETTING: Minnesota Eye Consultants, Minneapolis, Minnesota. METHODS: Retrospective, noncomparative interventional case series. RESULTS: We examined 6 eyes of 3 patients with asymmetrical preoperative pachymetry who developed persistent unilateral flap edema after uneventful myopic LASIK in the eye with thicker preoperative pachymetry. All cases had asymmetrical preoperative pachymetry with flap edema developing in the eye with higher preoperative mean central corneal thickness (CCT) values, preoperative mean CCT subject eye 622 microm (range 556-664 microm) versus fellow eye 583 microm (range 510-621 microm). There was no associated ocular inflammation or rise in intraocular pressure. Significant flap edema resolved on a combination treatment of topical steroid and hypertonic saline. CONCLUSIONS: Laser in situ keratomileusis can cause temporary endothelial cell dysfunction or stress, which manifests as temporary flap edema and subclinical corneal thickening. The edema appears to be limited to the actual flap and there was no loss of epithelial integrity in these eyes and no clinically noticeable interface fluid. This new clinical entity appears to occur in patients with asymmetrical preoperative corneal pachymetry and is associated with postoperative specular microscopy abnormalities. In cases with unexplained asymmetrical corneal thickness, preoperative evaluation should include specular microscopy to evaluate for risk features that may increase the chances of a slower postoperative recovery.

Cornea↗
PubMed2004

Objective interpretation of severity of SLS induced edema by stereoimaging.

BACKGROUND: In the evaluation of the severity of skin inflammations, visual scoring system is widely being used as a subjective method. However, it is well known that interobserver variations occur even between the interpretations of experienced dermatologists. OBJECTIVE: To develop a new objective and quantitative method for the evaluation of skin surface contours and for the assessment of severity in SLS-induced edema, a new investigatory tool based on the concept of "stereoimaging" was studied. Differences between binocular images were used by a stereoimage optical topometer (SOT) system capable of calculating skin surface topographic information, which was then used to produce a three-dimensional image. METHODS: We compared the results obtained by SOT with a visual scoring system after applying sodium lauryl sulfate (SLS) to skin. The degree of edema was assessed qualitatively by visual scoring (0: none, 1: mild edema, 2: moderate edema, 3: severe edema). To quantify the severity, five three-dimensional parameters (S(a), S(z), SL, SA and SV) were used in the SOT analysis. RESULTS: The means of these five parameters increased significantly in visual grade 1+ compared to visual grade 0 and the means of the five parameters decreased significantly and proportionally as the visual grades increased from 1+ to 3+. A highly significant correlation was found to exist between the visual scoring results and the five SOT parameters. CONCLUSION: SOT can be used to evaluate the severity of SLS-induced edema objectively and can be extensively applied to evaluate the degree of severity in other inflammatory skin conditions.

Adult↗
PubMed2005

Matrix metalloproteinase-9 contributes to brain extravasation and edema in fulminant hepatic failure mice.

BACKGROUND/AIMS: Fulminant hepatic failure (FHF) can be dreadful. When coma sets in, brain edema develops taking FHF into a lethal course. Mechanisms of brain extravasation leading to brain edema remain incompletely understood. Matrix metalloproteinase (MMP)-9 is implicated in various brain injuries. We hypothesized that MMP-9 contributes to brain edema in FHF. METHODS: MMP-9 and its proform were assayed using SDS-PAGE and in situ gelatin zymographies. Brain extravasation was assessed with Evans blue. Brain water was determined by specific gravity and astrocytic endfoot swelling by electron microscopy. FHF in mice was induced by azoxymethane. MMP inhibitor GM6001 and MMP-9 monoclonal antibody were used. RESULTS: Active MMP-9 was significantly increased at the onset of coma and brain extravasation in FHF mice. Blocking MMP-9 with either GM6001 or MMP-9 monoclonal antibody significantly attenuated brain extravasation, astrocytic endfoot swelling, and brain edema. Brains of FHF mice did not show MMP-9 activity. In contrast, livers of these animals showed marked up-regulation of MMP-9 activity. CONCLUSIONS: Our findings suggest that MMP-9 contributes to the pathogenesis of brain extravasation and edema in FHF. The necrotic liver is the source of MMP-9 in FHF. Inhibition of MMP-9 may protect against the development of brain edema in FHF.

Animals↗
PubMed2005

Selective inhibition of inducible nitric oxide synthase reduces neurological deficit but not cerebral edema following traumatic brain injury.

The role of inducible nitric oxide synthase (iNOS) in cerebral edema and neurological deficit following traumatic brain injury (TBI) is not yet clear-cut. Therefore, the aim of this study was to investigate the effect of three different iNOS inhibitors on cerebral edema and functional outcome after TBI. First, the time courses of blood--brain barrier (BBB) breakdown, cerebral edema, and neurological deficit were studied in a rat model of fluid percussion-induced TBI. The permeability of BBB to Evans blue was increased from 1 h to 24 h after TBI. Consistently, a significant increase in brain water content (BWC) was observed at 6 and 24 h post-TBI. A deficit in sensorimotor neurological functions was also observed from 6 h to 7 days with a maximum 24 h after TBI. Second, a single dose of aminoguanidine (AG; 100 mg/kg, i.p.), L-N-iminoethyl-lysine (L-NIL; 20 mg/kg, i.p.), or N-[3-(aminomethyl)benzyl]acetamide (1400W; 20 mg/kg, s.c.) was administered at 6 h post-TBI. Treatment with AG reduced by 71% the increase in BWC evaluated at 24 h, while L-NIL and 1400W had no effect. In contrast, the three iNOS inhibitors reduced the neurological deficit from 30% to 40%. Third, 1400W (20 mg/kg, s.c.) was administered at 5 min, 8 and 16 h post-TBI. Although this treatment paradigm had no effect on cerebral edema evaluated at 24 h, it significantly reduced the neurological deficit and iNOS activity. In conclusion, iNOS contributes to post-TBI neurological deficit but not to cerebral edema. The beneficial effect of iNOS inhibitors is not due to their anti-edematous effect, and the reduction of cerebral edema by AG is unlikely related to iNOS inhibition. The 6 h therapeutic window of iNOS inhibitors could allow their use in the treatment of functional deficit at the acute phase of TBI.

Amidines↗
PubMed2006

Ziprasidone-associated pedal edema in the treatment of schizophrenia.

It has been reported that second generation of antipsychotic drugs may induce pedal edema. The purpose of this case report is to demonstrate that the recently marketed antipsychotic drug, ziprasidone induced pedal edema with an increased plasma immunoglobulin E (IgE) level. A 51-year-old female schizophrenic patient who developed severe pedal edema was treated with ziprasidone for 6 weeks. Admission routine data that included biochemical, blood and urine analysis were normal except for the plasma IgE level, which was significantly elevated. Although the pedal edema subsided after discontinuation of ziprasidone and administration of diuretics, the plasma IgE level remained high. This is the first case report attempting to demonstrate the existence of ziprasidone-induced pedal edema in the treatment of schizophrenia. In this case, the pedal edema was associated with an IgE-related allergic reaction.

Antipsychotic Agents↗
PubMed2004

Effect of ifenprodil, a polyamine site NMDA receptor antagonist, on brain edema formation following asphyxial cardiac arrest in rats.

OBJECTIVE: Brain edema occurs in experimental and clinical cardiac arrest (CA) and is predictive of a poor neurological outcome. N-Methyl--aspartate (NMDA) receptors contribute to brain edema elicited by focal cerebral ischemia/reperfusion (I/R). Ifenprodil, a NMDA receptor antagonist, attenuates brain edema and injury size in rats after focal cerebral I/R. We assessed the hypothesis that ifenprodil reduces CA-elicited brain edema. METHODS: Eighteen male Sprague-Dawley rats were assigned to group 1 (normal control, n=6), group 2 (placebo-treated CA, n=6), or group 3 (ifenprodil-treated CA, n=6). CA was induced by 8 min of asphyxiation and the animals were resuscitated with cardiopulmonary resuscitation (CPR), ventilation, epinephrine (adrenaline), and sodium bicarbonate (NaHCO3). Ifenprodil of 10 mg/kg or a placebo vehicle was given intraperitoneally 5 min before CA. Brain edema was determined by brain wet-to-dry weight ratio at 1 h after resuscitation. RESULTS: There were no differences between groups 2 and 3 in all physiological variables at baseline. Time from asphyxiation to CA was 201.5 +/- 7.5 s in group 2 and 160.7 +/- 10.4 s in group 3 (P<0.001). Resuscitation time was 68.2 +/- 13.3 s in group 2 and 92.8 +/- 18.2 s in group 3 (P<0.05). Ifenprodil decreased mean arterial pressure (MAP) before asphyxiation, from 128 +/- 7 in group 2 to 82 +/- 15 mmHg in group 3 (P<0.001), and negated immediate post-resuscitation hypertension. Brain wet-to-dry weight ratio was 5.64 +/- 0.44 in group 1, 7.34 +/- 0.95 in group 2 (P<0.01 versus group 1), and 5.93 +/- 0.40 in group 3 (P<0.05 versus group 2). CONCLUSIONS: Ifenprodil reduces CA-elicited brain edema. In addition, we observed significant hemodynamic changes caused by ifenprodil.

Animals↗
PubMed1988

Systemic tocolysis for premature labor is associated with an increased incidence of pulmonary edema in the presence of maternal infection.

Our hypothesis is that systemic tocolysis of patients in premature labor is associated with a higher incidence of pulmonary edema in the presence of maternal infection. Over a 64-month period, medical records of all patients with a diagnosis at discharge of pulmonary edema or congestive heart failure were reviewed. There were 27 cases of pulmonary edema, 16 of which (59.3%) were associated with treatment of preterm labor. The incidence of pulmonary edema in patients receiving systemic tocolysis for treatment of preterm labor was significantly higher than that in our general obstetric population (3.04% versus 0.05%). Of the 527 patients receiving tocolysis, there was evidence of maternal infection in 52. The incidence of pulmonary edema was higher in the presence of maternal infection than in its absence (11/52 or 21% versus 5/475 or 1%, p = 0.0000). We conclude that there is a very strong association between the development of pulmonary edema and the presence of maternal infection in patients being treated for premature labor with systemic tocolysis.

Female↗
PubMed2000

Vitrectomy for diffuse diabetic macular edema associated with a taut premacular posterior hyaloid.

PURPOSE: To evaluate the role of vitrectomy in eyes with diffuse diabetic macular edema associated with a taut posterior hyaloid. METHODS: Records of 55 eyes of 50 patients with diabetic retinopathy and diffuse clinically significant diabetic macular edema who underwent vitrectomy with stripping of the premacular posterior hyaloid were reviewed. In all 55 eyes, diffuse diabetic macular edema was present on contact lens examination and confirmed with fluorescein angiography. On fundus examination, the premacular posterior hyaloid was attached and appeared taut. RESULTS: The mean preoperative best-corrected visual acuity was 20/160, and the mean final best-corrected visual acuity was 20/80 (P <.0001, Wilcoxon signed rank test), with 27 (49.1%) of the 55 eyes demonstrating improvement in best-corrected visual acuity of 2 or more lines. Fifty-two (94.5%) of the 55 vitrectomized eyes showed improvement in clinically significant macular edema and in 45 eyes (81.8%) the macular edema resolved completely during a mean period of 4.5 months (range, 1 to 13 months). Eyes with macular ischemia and preoperative best-corrected visual acuity of 20/200 or less tended to respond less favorably to vitrectomy than eyes lacking these characteristics. All eyes had at least 6 months of follow-up after surgery, with a mean follow-up of 23.2 months. CONCLUSION: In eyes with persistent diffuse diabetic macular edema with a taut premacular posterior hyaloid face unresponsive to laser therapy, vitrectomy with removal of the posterior hyaloid appears to be beneficial in some cases. Careful selection of eyes with favorable preoperative clinical characteristics may improve surgical outcomes.

Adult↗
PubMed2002

Cystoid macular edema in the era of ocular hypotensive lipids.

PURPOSE: To review cystoid macular edema in relationship with ocular hypotensive lipids and to present recommendations for use in eyes at increased risk of cystoid macular edema. DESIGN: Focused literature review and authors' clinical experience. METHODS: Cystoid macular edema in association with cataract surgery, epinephrine therapy, and ocular hypotensive lipid therapy is reviewed. RESULTS: Cystoid macular edema may be associated with a variety of therapeutic interventions, predominantly in eyes at increased risk with open or absent posterior lens capsule and ocular inflammation. Based primarily on experience with latanoprost, the association between ocular hypotensive lipids and cystoid macular edema, even in high-risk eyes, although present, appears to be low. CONCLUSIONS: Considering the low incidence of cystoid macular edema associated with latanoprost therapy, the authors feel that after maximal tolerable medical therapy and with proper precautions, the use of an ocular hypotensive lipid is an acceptable alternative to filtration surgery in high-risk eyes.

Adrenergic Agonists↗