The issue of chronic macular edema

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With availability of dexamethasone implant and ranibizumab, specifically indicated for the treatment of macular edema complicating RVO, a trend could be to treat as quickly as possible all retinal thickenings by intravitreal injections (more or less often, depending on duration of action of selected product). However, all retinal thickenings are not identical, nor from the same origin. Fine semiological analysis allows to distinguish different types : in addition to macular edema by blood-retinal barrier rupture (most common), we will describe other involved mechanisms, like macro-aneurysms, ischemia, diffusion of papilledema, epi-retinal membrane. Differentiation of mechanism is important because involving different therapeutic approaches.

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