In a previous question posted June 16, Dr. Brown indicated that diabetes and high blood pressure, even if well controlled, are contributing factors to the development of retinal swelling after cataract surgery. I would like to read more about this. Could you suggest resources or published studies backing this up?
I have corresponded on this site for three years post-lens replacement surgery with very persistent chronic CME that is refractory to treatment of every possible kind you can name. One retina specialist is most lately suggesting a membrane peel at this point, hypothesizing that epiretinal membrane traction is the cause. This is his hypothesis since there is no inflammatory source, no vitreous traction because I had vitrectomy, no retinal vein occlusion, no diabetes. Could it be something as simple as blood pressure? I have mild high blood pressure that is well controlled with 10 mg daily lisinopril. I would like to know what studies show about this.Can you help?
At this stage, trying to figure out the actual cause isn't really going to help much. What would you do different. You need to control your blood pressure and glucose anyway. It is very well documented that CME can occur even in totally normal eyes with perfect surgery. Diabetes is definitely a huge factor. The newer high definition OCT units should be able to find any anatomical problems like vitreomacular traction, I would look out for things like prostaglandin drops for glaucoma which can contribute to CME, and maybe chronic hypertension, smoking, high cholesterol, diabetes and things like that which could compromise the integrity of macular circulation. Some studies have indicated that avastin or lucentis may possibly have a role to play in the treatment of select cases of CME but no definitive studies. Chronic CME can be very, very difficult to improve. You can always utilize pubmed and use key words cystoid macular edema, treatment, causes.
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