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Review
, 10 (1), 127

Cystoid Macular Edema Associated With Preservative-Free Latanoprost After Uncomplicated Cataract Surgery: Case Report and Review of the Literature

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Review

Cystoid Macular Edema Associated With Preservative-Free Latanoprost After Uncomplicated Cataract Surgery: Case Report and Review of the Literature

Olga E Makri et al. BMC Res Notes.

Abstract

Background: Cystoid macular edema associated with latanoprost administration has been reported in patients after complicated cataract surgery with coexisting risk factors. We present the first case of preservative free latanoprost associated cystoid macular edema that occurred many months after uncomplicated cataract surgery.

Case presentation: A 65-year old Caucasian female presented in the Outpatients Clinic complaining of reduced vision and metamorphopsia in the right eye. She had undergone uneventful phacoemulsification 19 months ago in the right eye and was under treatment with preservative free latanoprost eye drops for the last 7 months for ocular hypertension. Her remaining medical and ocular history were otherwise unremarkable. Cystoid macular edema with serous retinal detachment was diagnosed in the right eye using optical coherence tomography and fluorescein angiography. Latanoprost was discontinued and brinzolamide and nepafenac eye drops were administered in the right eye. Two months later, cystoid macular edema completely resolved with restoration of visual acuity. Nepafenac eye drops were administered for another 2 months. Eight months after latanoprost cessation optical coherence demonstrated no sign of cystoid macular edema whereas a subtle epiretinal membrane was noted.

Conclusions: Cystoid macular edema may potentially occur in patients receiving preservative free latanoprost. More interestingly, in our case it was diagnosed in a patient with a long standing pseudophakia after uncomplicated phacoemulsification. No obvious risk factor for macular edema development was recognized. Prompt diagnosis and latanoprost discontinuation resulted in complete resolution of the cystoid macular edema and functional restoration of the eye.

Keywords: Cystoid macular edema; Latanoprost; Preservative free; Uncomplicated phacoemulsification.

Figures

Fig. 1
Fig. 1
a Optical coherence tomography of right eye before latanoprost administration. No pathology is detected. b Seven months after treatment with preservative free latanoprost optical coherence tomography in right eye revealed cystoid macular edema with well-defined, intraretinal cystic areas of low reflectivity in the macula with serous retinal detachment. c Two months after latanoprost discontinuation optical coherence tomography demonstrated complete resolution of cystoid macular edema. A subtle epiretinal membrane is noted
Fig. 2
Fig. 2
a Fluorescein angiography in the right eye revealed a petaloid leakage from the perifoveal retinal capillaries during the late phases without staining of the optic disc. Multiple areas of subtle fluorescein leakage were noted throughout the retina. b No leakage or any other pathology was observed in the left eye

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