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Manage macular edema after PPV

机译：PPV后处理黄斑水肿

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Incidence of CMEAfter retinal detachment surgeryBerrod et al reported that the incidence of CME was 7% after vitrectomy. Risk factors noted for CME were a smaller axial length (p Figure 1. A. CME in patient with silicone oil. B. OCT 10 days after silicone oil removal shows resolution of CME in the same patient.After PPV for epiretinal membrane (ERM)The cause for edema is unclear. One theory is that peeling off the membrane causes mechanical trauma leading to accumulation of fluid.Alam et al showed that the incidence of CME after PPV and ERM peel was 12.8%. They also showed that intravitreal triamcinolone acetonide resulted in a significant decrease in macular edema with a significant gain in vision 1 month after treatment. These were cases of recalcitrant CME after PPV.7A study by Hattenbach et al evaluated the outcome of a 0.7-mg sustained-release intravitreal dexamethasone implant (Ozurdex, Allergan) for postoperative CME after PPV and ERM peel. Results of 39 eyes with chronic CME resistant to prior topical NSAID therapy showed a statistically significant decrease in central retinal thickness and improvement in vision.8Chen et al evaluated the effects of intravitreal bevacizumab (Avastin, Genentech) for persistent CME after ERM surgery. They did not find a statistically significant improvement in central macular thickness or vision between the treatment and control groups.9After PPV for retained lens fragmentsScott et al noted CME in up to 28% of eyes after PPV for retained lens fragments; the CME became chronic in about 20% of these eyes. After vitrectomy, inflammatory mediators can probably more easily diffuse from the iris and anterior chamber to the macula, causing CME.10.
机译：视网膜脱离手术后CME的发生率Berder等报道玻璃体切除术后CME的发生率为7％。注意CME的危险因素是轴向长度较小（p图1. A.含硅油患者中的CME。B.去除硅油后10天的OCT显示同一患者中CME的消退。PPV后为视网膜前膜（ERM）水肿的原因尚不清楚，一种理论是剥离膜会引起机械损伤，导致积液，Alam等人表明PPV和ERM剥离后CME的发生率为12.8％，还表明玻璃体内曲安奈德可导致治疗后1个月，黄斑水肿明显减轻，视力明显改善。这是PPV后顽固性CME的病例。Hattenbach等人的7A研究评估了0.7毫克缓释玻璃体内地塞米松植入物（Ozurdex， PPV和ERM剥离后用于术后CME的Allergan）。39眼慢性CME对先前的局部NSAID治疗有抵抗力的结果显示，中央视网膜厚度和近端眼球减少明显8 Chen等人评估了玻璃体内贝伐单抗（Avastin，Genentech）对ERM手术后持续CME的影响。他们在治疗组和对照组之间未发现统计学上显着的黄斑中央厚度或视力改善。9PPV保留晶状体碎片后，Scott等人指出，PPV保留晶状体碎片后，高达28％的眼睛为CME。在约20％的这些眼睛中，CME呈慢性。玻璃体切除术后，炎症介质可能更容易从虹膜和前房扩散到黄斑，引起CME.10。

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