How to organise the follow-up of patients with macular edema?

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Abstract

The results of clinical trials have demonstrated significant visual and anatomic benefits to intravitreal agents in the treatment of the macular edema (MO) related to retinal ischemic microangiopathies. Following the evaluation of non-perfused capillary areas, on fluorescein angiography, spectral domain optical coherence tomography (OCT) helps to quantify the amount of cystoid macular edema. The clinical examination include VA assessment, biomicroscopy and OCT. Important differences exist in the protocols evaluating treatment for Diabetic MO, from the mandatory monthly anti VEGF injections, to either protocol, requiring injections during the first 4 study visits and prompt or deferral laser or in trials, where patients, after 3 mandatory monthly injections, had both a variable dose and injection, based on VA and OCT evaluation. The MO related to RVO should be monitored monthly for the first 3 months, and then every 2 months for the first year. During this monitoring period, patients should be instructed to return promptly whenever they notice a decrease in vision, a possible indication of macular edema, or the conversion to ischemia. Follow-up after the initial 6 months will be required

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