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THE NATURAL HISTORY OF TRACTIONAL CYSTOID MACULAR EDEMA

Charalampidou, Sofia MRCOphth*; Nolan, John PhD; Beatty, Stephen FRCOphth*,†

doi: 10.1097/IAE.0b013e3182561fe6
Original Study

Background: To describe clinical outcomes in a series of patients with tractional cystoid macular edema, a variant of vitreomacular traction syndrome.

Methods: Twelve consecutive patients (15 eyes) with tractional cystoid macular edema of maximum diameter of ≤550 μm and presenting corrected-distance visual acuity of ≤0.3 (Snellen ≥20/40) were studied. Each patient underwent ophthalmic examination, including visual acuity testing in the logarithm of the minimal angle of resolution system, slit-lamp biomicroscopy, and optical coherence tomography. All patients were monitored at four-monthly intervals, unless a subjective change in symptoms prompted earlier follow-up.

Results: The mean corrected-distance visual acuity (±standard deviation) at presentation was 0.17 (Snellen 20/30) (±0.17). The mean (±standard deviation) maximum diameter of vitreofoveolar adhesion was 267 (±139) μm. After a mean follow-up of 9.2 (±7.4) months, 8 eyes exhibited spontaneous and complete posterior vitreous detachment, with resolution of the tractional cystoid macular edema and restoration of normal foveal anatomy in 6 of these eyes and persistence of a single foveal cyst in 2 of these eyes. The final corrected-distance visual acuity (±standard deviation) in the 5 eyes that underwent spontaneous and complete posterior vitreous detachment improved from 0.20 (Snellen 20/32) (±0.13) to 0.16 (Snellen 6/8) (±0.12; P = 0.53).

Conclusion: Complete posterior vitreous detachment occurred spontaneously in 53% of eyes with tractional cystoid macular edema in this series.

Tractional cystoid macular edema can resolve spontaneously in a substantial proportion of cases within months of presentation.

*Institute of Eye Surgery and Institute of Vision Research, Whitfield Clinic, Waterford, Ireland

Macular Pigment Research Group, Waterford Institute of Technology, Waterford, Ireland.

Reprint requests: Sofia Charalampidou, MRCOphth, Institute of Eye Surgery, Whitfield Clinic, Cork Road, Waterford, Ireland; e-mail: sonia.sofia1@gmail.com

Presented at the Irish College of Ophthalmologists' Annual Conference, Dublin, Ireland, April 30, 2010, and at the XVIII Congress of the European Society of Cataract and Refractive Surgeons, Paris, France, September 5, 2010.

The authors have no financial or proprietary interest in any material or method mentioned in this article.

© The Ophthalmic Communications Society, Inc.