A study from the United States has highlighted the need for standardised treatment guidelines for cases of pseudophakic cystoid macular oedema (PCMO), a condition that can occur in patients following cataract surgery.
Although 80% of patients experience spontaneous resolution after three to 12 months, in persistent cases, PCMO can lead to permanent vision loss.
In the study, in BMC Ophthalmology, 1 the authors noted that there are “currently no uniform diagnosis criteria” for the condition. Common methods of diagnosis include angiographic findings, decreased visual acuity, and optical coherence tomography (OCT).
The incidence rate of uncomplicated PCMO is estimated to be 2.3% and “treatment is variable and based on provider preference because there are no standardised treatment guidelines”.
The article said while literature describes treatment as a stepwise approach starting with topical monotherapy, then topical dual therapy, and eventually periocular or intraocular injectables as lastline options in prolonged or nonresponsive cases, analysis “showed deviations in this approach”.
“The consequences of this clinical variation may contribute to worse clinical outcomes and excess costs and resource use as physicians are left to trial and error with different therapies in the absence of standardised clinical guidelines.”
The study noted that PCMO was a “significant economic burden” with more than 5.1 follow-up ophthalmologist appointments per case, and concluded that the “creation of best practices” for treatment to reduce variability and waste” was essential.
1. Ahmadyar, G., Carlson, J.J., Kimura, A. et al., Real-world treatment patterns and economic burden of post-cataract macular edema. BMC Ophthalmol 23, 380 (2023). doi.org/10.1186/s12886-023-03113-x.