The Use of Retinal Tomography in the Diagnosis and Treatment of Post-Cataract Extraction Cystoid Macula Edema

Abstract

Abstract: : Purpose: To determine if the Heidelberg Macula program can detect post cataract extraction cystoid macula edema and to determine if it is useful in following the course of the disease. Methods: Thirteen patients with 20/20 vision status post cataract extraction were scanned with the HRT macula program. Scans were performed post-op day 1 and then weekly to detect the development of cystoid macula edema (CME). Foveal thickness was measured and followed throughout the postoperative course. Any patient that had a decrease in visual acuity or a MHRT edema thickness of 2.0 or greater went on to have an Intravenous Fluorescein Angiogram (IVFA). Results: 10 patients maintained a visual acuity of 20/20 or better and had macular thickness of < 2.0 on all scans. 3 patients had a decrease in visual acuity. These patients were found to have a macula thickness greater than 2.0 on HRT and were documented to have CME by IVFA. Patients that had a decrease in visual acuity had a macular thickness of >2.0 and CME confirmed by IVFA. When treated patients’ vision improved, we noted a corresponding decrease in macula thickness on MHRT and decreased leakage on IVFA. In addition, when CME resolved after treatment the macula thickness also decreased to less than 2.0. Conclusions: Macular HRT is an excellent way to screen patients requiring an IVFA, and follow the progression and resolution of cystoid macular edema in post-cataract extraction patients. Our study indicates that when macula thickness is >2.0, macula edema is present and there may be a corresponding decrease in visual acuity.

Keywords: cataract • imaging/image analysis: clinical • retinal degenerations: cell biology