REFRACTORY CYSTOID MACULAR EDEMA

I am in desparate need of expert advice.
1. Can CME (macular edema) ever be permanent?????...and what happens if it is?? I know there must be a source of chronic irritation for it to not respond the the best treatments available (Avastin), but what if the source of irritation is unresolvable and the problem never goes away????
2. Also, can long hours in front of a computer harm the retina when one has had, by age 48, both clear silicone implants that do not filter high-energy blue light, as well as a vitrectomy to remove virtually all light filtration to the retina???

Yes, this is my situation 2 years post-Crystalens surgery and 7 months of treatment for CME. HELP! My doctors are lost!  Dr. Kutryb is somewhat familiar with this.

[Sandy Feldman, MD, MS]

Dear Buttercup109,
CME or cystoids macular edema is swelling in the area of one’s central vision. I would recommend that you seek the care of an eyeMD specializing in retina.  Sometimes, one can develop inflammation after cataract surgery that can contribute to the macular edema.  Cystoid macular edema also occurs in individuals with diabetes, uveitis [inflammation inside the eye] or after retinal vein occlusions.  It is not likely that computer use is the cause of your chronic condition.  The treatment of CME can include topical steroid and non-steroidal anti-inflammatories, oral or injected anti-inflammatories, and diuretics such as diamox.  If the cause can be elucidated, then further treatment can be aimed at that.  Should the CME not improve despite all of these, the vitrectomy and the vision loss substantial, an IOL exchange can be performed.  Sometimes, it can take a long time for the edema to improve after addressing the cause.

Dr. Feldman

Sandy T. Feldman, M.D., M.S.
ClearView Eye and Laser Medical Center
San Diego, California