Edema macular

Blunt trauma to eye Macular edema Retinal detachment Sudden congestive proptosis (bulging of eye forward) Corneal ulcer Corneal abrasion... 

M/sce/Zaneoas. Atrial fibrillation and other cardiac arrhythmias, cystoid macular edema, decreased glucose tolerance, hypotension, orthostasis, toxic amblyopia, transient headache. 

Ophthaimoiogic disorders Decrease or loss of vision, retinopathy (including macular edema, retinal artery or vein thrombosis), retinal hemorrhages and cotton wool spots, optic neuritis, and papilledema are induced or aggravated by treatment with peginterferon alfa-2a or other alpha interferons. All patients should receive an eye examination at baseline. 

Adverse reactions may include transient stinging and burning eye pain/ache browache headache allergic lid reaction conjunctival hyperemia conjunctival or corneal pigmentation ocular irritation (hypersensitivity) localized adrenochrome deposits in conjunctiva and cornea (prolonged use) reversible cystoid macular edema (may result from use in aphakic patients) palpitations tachycardia extrasystoles cardiac arrhythmia hypertension faintness. 

Aphakic patients Macular edema occurs in up to 30% of aphakic patients treated with epinephrine. Discontinuation generally results in reversal of the maculopathy. 

Macular edema Macular edema, including cystoid edema, has been reported during treatment with prostaglandin agonists. 

Unlabeled Uses Treatment of vascular headaches (oral) to reduce the occurrence and severity of cystoid macular edema after cataract surgery (ophthalmic form)... 

Inflammation (iritis/uveitis) and macular edema, including cystoid macular edema, have been reported. 

CNS Bowel Dysfunction Other Edema, macular edema... 

Usewith caution in older patients with CHF, CAD, NYHA Class 111 or IV, Hepatic impairment (avoid if ALT >2.5 times the upper li mit of normal), Diabetic macular edema... 

Intravitreal triamcinolone injection is safe and effective for cystoid macular edema caused by uveitis, diabetic maculopathy, and central retinal vein occlusion, and for pseudophakic cystoid macular edema. Potential risks include glaucoma, cataract, retinal detachment, and endophthalmitis. Infectious endophthalmitis is extremely rare when appropriate sterile technique is practised. Seven patients developed a clinical picture simulating endophthalmitis after intravitreal injection of triamcinolone (71). The authors believed that this effect was a toxic reaction to the injected material and explained that the differential diagnosis of infectious endophthalmitis in eyes that have been injected with triamcinolone under sterile conditions includes a sterile toxic endophthalmitis that requires careful monitoring, perhaps every 8-12 hours, in order to determine whether the inflammation is worsening or improving. Resolution occurs spontaneously, and in the absence of eye pain unnecessary intervention can be avoided. 

Hypopyon associated with non-infectious endophthalmitis after intravitreal injection of triamcinolone has been described previously (72). Pseudohypopyon and sterile endophthalmitis after intravitreal injection of triamcinolone for pseudophakic cystoid macular edema has been reported (73). 

Cystoid macular edema, iritis, Herpes simplex keratitis, periocular skin darkening, and headaches have been described in patients treated with prostaglandin analogues. These adverse effects occur rarely, and cystoid macular edema, iritis and H. simplex keratitis occur in eyes with risk factors. Repeated rechallenge with masked controls is required to establish a causal relation. However, even without firm establishment of a causal relation, caution is advised with the use of prostaglandin analogues in the eyes of patients with risk factors for macular edema, iritis, and H. simplex keratitis (76). 

The ocular adverse effects of latanoprost include conjunctival hyperemia, iris pigmentation, periocular skin color changes, anterior uveitis, and cystoid macular edema in pseudophakic patients (77,78). H. simplex dendritic keratitis has been reported after treatment with latanoprost (79). In patients with uveitic glaucoma, latanoprost can cause increased intraocular pressure and recurrence of inflammation (80). 

Cystoid macular edema developed in two patients treated with topical latanoprost for glaucoma (23). Latanoprost was withdrawn, and the cystoid macular edema was treated with topical corticosteroids and ketorolac, with improvement in visual acuity. The macular edema resolved in both cases. 

Cystoid macular edema has been reported in four other patients shortly after they started to use latanoprost (24) and other reports have appeared (25-29). A possible explanation is enhanced disruption of the blood-aqueous barrier induced by latanoprost (28). 

A review of the published literature (28 eyes in 25 patients) has shown that in all cases there were other associated risk factors, so that a definitive conclusion about a causal relation cannot be reached (30). Nevertheless, latanoprost should be used with caution in patients with risk factors for cystoid macular edema and special surveillance is necessary. 

Callanan D, Fellman RL, Savage JA. Latanoprost-asso-ciated cystoid macular edema. Am J Ophthalmol 1998 126(l) 134-5. 

Ayyala RS, Cruz DA, Margo CE, Harman LE, Pautler SE, Misch DM, Mines JA, Richards DW. Cystoid macular edema associated with latanoprost in aphakic and pseudo-phakic eyes. Am J Ophthalmol 1998 126(4) 602-4. 

Gaddie IB, Bennett DW. Cystoid macular edema associated with the use of latanoprost. J Am Optom Assoc 1998 69(2) 122-8. 

Heier JS, Steinert RF, Frederick AR Jr. Cystoid macular edema associated with latanoprost use. Arch Ophthalmol 1998 116(5) 680-2. 

Miyake K, Ota I, Maekubo K, Ichihashi S, Miyake S. Latanoprost accelerates disruption of the blood-aqueous barrier and the incidence of angiographic cystoid macular edema in early postoperative pseudophakias. Arch Ophthalmol 1999 117(l) 34-40. 

Moroi SE, Gottfredsdottir MS, Schteingart MT, Elner SG, Lee CM, Schertzer RM, Abrams GW, Johnson MW. Cystoid macular edema associated with latanoprost therapy in a case series of patients with glaucoma and ocular hypertension. Ophthalmology 1999 106(5) 1024-9. 

Schumer RA, Camras CB, Mandahl AK. Latanoprost and cystoid macular edema is there a causal relation Curr Opin Ophthalmol 2000 11(2) 94-100. 

There have been repeated reports of ophthalmic complications from tamoxifen, including irreversible retinopathy with seriously reduced visual acuity, retractile opacities, cystoid macular edema, retinal yellow-white dots, and keratopathy (SEDA-6, 356 SEDA-7, 391 SEDA-16, 466). 

Macular edema has been associated with rosiglitazone (67). 

There have been several other reports of this rare adverse effect of rosiglitazone, which has been added to the SPC. Caution should be taken and appropriate followup should take place when rosiglitazone is added to the therapy of someone at risk of macular edema. 

Colucciello M. Vision loss due to macular edema induced by rosiglitazone treatment of diabetes mellitus. Arch Ophthalmol 2005 123 1273-5. 

An obese 31-year-old man developed non-proliferative retinopathy and macular edema with reduced visual acuity after 14 months therapy, which improved after somatropin was withdrawn. 

A few cases of advanced cystoid macular edema have been reported in the older literature these took months to resolve once nicotinic acid was withdrawn (SEDA-14, 331 SEDA-20, 191 15,20). Four new cases have been added in patients who took nicotinic acid 2-4.5 g/day (21,22). The first symptoms of blurred vision appeared 1-18 months after the start of therapy. Withdrawal of nicotinic acid resulted in improvement of visual acuity and resolution of the cystoid macular edema within 1-2 months. A particular feature that distinguishes this form of maculopathy is the absence of leakage on fluorescein angiography. Retinal edema, when it occurs, will abate on withdrawal of nicotinic acid (15). 

Callanan D, Blodi BA, Martin DF. J Macular edema with nicotinic acid (niacin). J Am Med Assoc 1998 279 1702. 

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