By G. Coscas, J. Cunha-Vaz, A. Loewenstein, G. Soubrane, F. Bandello
For a few years, diagnosing macular edema at an early degree has been a major trouble. lately, a number of and noteworthy advances of recent imaging applied sciences which enable acceptance of the most etiologies, have immensely superior its analysis and remedy. during this quantity, diversified styles and etiologies of macular edema are defined and the significance of conserving the photoreceptors at an early level with a view to continue heart visible acuity is mentioned. It brings jointly the newest facts and evidence-based drugs, and, however, the pathophysiological foundation of macular edema and different methods for drug supply to the posterior phase are awarded. strategies for remedy strategies or various cures were conscientiously analyzed and regarded sooner than inclusion. "Macular Edema - a pragmatic process" presents the ophthalmologist with a synthesis of data to diagnose, to figure out etiology, and to provide the sufferer workable treatments for his gain.
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Extra resources for Macular Edema: A Practical Approach (Developments in Ophthalmology)
34. Idiopathic macular telangiectasias. Infrared retinography. Fig. 35. Idiopathic macular telangiectasias. Red-free imaging. White arrow = CME; orange arrow = areas of macular pigment loss. round zones, and the highest central autofluorescence of longstanding cysts may suggest the loss of foveal macular pigments and photoreceptors. A correlation can be shown between areas of increased confocal blue reflectance and increased autofluorescence in the perifoveal region. In FA (fig. 37, 38), parafoveal telangiectatic capillaries can be detected in the early angiographic phases (fig.
FA, advanced CNV. White arrow = CME; red arrowhead = hard exudates; black arrow = retinal pigment epithelium detachment. technology, OCTs are able to acquire high-definition images, which allow the operator to identify even extremely small cysts in the earliest phases of the disease and to describe their distribution into the different retinal layers. Depending on lesion type and in the early phases of the disease, CME shows different patterns of localization: classical lesions usually present intraretinal fluid localized in small cystic spaces primarily disposed into the internal layers 44 (nuclear and plexiform; fig.
41, 46). Small round/oval structures with circular 46 midreflectant elements and a central brighter core, which can be observed surrounded by a crown of hyperreflectant spots, can be confused with CME. These formations, called a ‘rosette’ or ‘outer retinal tubulation’, represent a stability mark of the lesion (fig. , 2009)19. Staurenghi и Invernizzi и de Polo и Pellegrini Fig. 47. AMD. OCT, advanced CNV. Arrowheads = Outer retinal tubulations. Table 2. Summary of examination methods Fundus photography Retinography FA ICGA OCT Irvine-Gass syndrome R S U – U Diabetic retinopathy U U U R U Retinal vein occlusions U U U – U Uveitis U R U U S Vitreoretinal tractions S U R – U Idiopathic macular telangiectasias S U S R U AMD S S U U U ICGA = Indocyanine green angiography; AMD = age-related macular degeneration; R = rarely useful; S = sometimes useful; U = usually useful; – = usually not performed.
Macular Edema: A Practical Approach (Developments in Ophthalmology) by G. Coscas, J. Cunha-Vaz, A. Loewenstein, G. Soubrane, F. Bandello