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Samuel H. Lee, Sara Modjtahedi, Kuumba Long, David G. Telander, Robert J. Zawadski, Susanna Park, Lawrence Morse, Jeffrey J. Caspar; Update On Pseudophakic CME: High Resolution Insights For Those Patients That Don't Return To 20/20. Invest. Ophthalmol. Vis. Sci. 2011;52(14):4515.
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© ARVO (1962-2015); The Authors (2016-present)
Optical Coherence Tomography (OCT) is used to diagnose and managemacular edema. Of the newer OCT instruments, our high resolutionexperimental Fourier-domain OCT allows near histologic levelsof resolution. We evaluated patients with resolved pseudophakicCME with suboptimal final visual acuity to evaluate for anysubclinical pathology.
A retrospective chart review was performed of patients withthe diagnosis of pseudophakic CME from June 2005 to March 2009.Patients were included if they were treated, with subsequentresolution of CME on Cirrus OCT with a best corrected visualacuity of less than 20/20 without other ocular pathology. Experimentalhigh resolution OCT was obtained and compared with previousCirrus OCT images.
Of the 3811 patients that underwent cataract surgery duringthat time period, there were 7 eyes from 6 patients that wereincluded. Pathology was evident in all of the 7 eyes on high-resolutionOCT, including epiretinal membranes and a distortion of Verhoeff’smembrane. This includes pathology that was not detected on imagesobtained from commercially available OCT instruments.
This study demonstrates that cystoid macular edema, even afterresolution, may be associated with a distortion of Verhoeff’smembrane, which may potentially explain this previously unexplainedvision. This study also serves to demonstrate the utility ofobtaining high resolution images of the macula in the contextof unexplained vision loss in the setting of a normal OCT.
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