Cystoid Macular Oedema (CME) is a painless condition in which the central retina or macula is affected. When a patient presents with Cystoid Macular Oedema, Optical Coherence Tomography (OCT) reveals multiple cyst-like pockets of fluid appear within the macula and around the fovea and result in retinal swelling or edema causing retinal thickening of the macula due to disruption of the typical blood-retinal barrier, this leads to leakage from the perifoveal capillaries, resulting in fluid accumulation within the intracellular spaces of the retina, primarily within the outer plexiform layer and inner layers of the retina. Thickened fovea, possible small elevation about retinal pigment epithelium (RPE) and central map thickness may also be present on OCT examination.
CMO most commonly occurs following cataract surgery, although it may accompany a number of diseases such as Retinal Vein Occlusion (RVO), uveitis or diabetes. About 1 - 3% of patients who have cataracts removed surgically will experience decreased vision as a result of CMO, the onset is usually within a few weeks post-op, if the condition presents in one eye, there is a greater risk (possibly as high as 50%) of it also affecting the other eye, if a patient who has had recent eye surgery develops CMO, it is due to normal post-operative inflammation causing the blood vessels in the center of the retina to leak, as leakage occurs the tissues swell, which can then lead to blurred or distorted vision.
Although oral medication is sometimes used to treat CMO, the majority of patients are treated using anti-inflammatory eye drops, although in some cases, surgery or ocular injections are often recommended in order to relieve pressure. Fortunately, patients presenting with CMO recover their vision with observation or treatment. Cystoid Macular Oedema following cataract surgery usually has an excellent prognosis as the majority of cases respond to medical treatment. When the CME resolves, vision returns to normal.
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