Cystoid macular edema (CME) also known as Irvine Gass Syndrome is a painless disorder affecting the central retina or macula. This condition is characterized by multiple cysts like areas of fluid in the macula causing retinal swelling or edema. CME is the retinal thickening of macula due to disruption of the normal blood-retinal barrier which leads to leakage from the perifoveal retinal capillaries causing accumulation of fluid within the intracellular spaces of the retina, mainly in the outer plexiform layer. CME is of two types: pseudophakic and nonpseudophakic cystoid macular edema. Pseudophakic cystoids macular edema is when the cause of occurrence is known while nonpseudophakic is the condition where no specific clinical findings have been observed. Symptoms of cystoids macular edema are blurred or decreased central vision.
The cause of CME is not completely known though it may be accompanied by various diseases such as uveitis, vein occlusion or diabetes. It is also known to occur commonly after cataract surgery. Various risk factors associated with cystoids macular edema are penetrating keratoplasty (corneal transplant), retinal surgery, chronic renal failure, retinal vein occlusion, retinitis pigmentosa, systemic medication and topical prostaglandin analogs for glaucoma..No significant racial or sex related predilection exists for this condition. However, cystoids macular edema can occur at any age based on the etiology, though advanced age is at higher risk.
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The global cystoids macular edema market can be segmented based on diagnosis, therapy, and geography. Drug class segment comprises non steroidal anti-inflammatory drugs, anti- vascular endothelial growth factor (VEGF) agents, carbonic anhydrase inhibitors and steroids. Generally anti inflammatory agents such as corticosteroids and diuretics including acetazolamide are used to treat retinal inflammation. These drugs may be given in the form of eye drops, injection or by oral administration. In certain cases anti- vascular endothelial growth factor (VEGF) is administered or a laser procedure is carried out to eliminate macular edema. Anti-VEGF therapies with ranibizumab or bevacizumab have demonstrated positive outcomes.
Surgical options to treat cystoids macular edema include laser photocoagulation, and vitrectomy. Laser photocoagulation is a therapeutic technique that uses light soured to coagulate tissue. Diagnostic tests include color fundus photography, fluorescein angiography, optical coherence tomography, and auto fluorescence. Out of all these techniques, optical coherence tomography which is a type of visual biopsy provides examination with highest sensitivity and allows early detection though fluorescein angiography is considered as a gold standard. Optical CT helps to confirm diagnosis as well as monitor progress of cystoid macular edema. Tests such as fasting blood sugar, lipid profile and blood pressure, are recommended if conditions such as diabetes or retinal vein occlusion are suspected.
Geographically, the cystoids macular edema market can be categorized into four major regions namely North America, Europe, Asia Pacific and Rest of the World. In the U.S., nearly 7,700 cataract surgeries are performed per day Some of the key players contributing to the global cystoids macular edema market are The EMMES Corporation, Fovea Pharmaceuticals SA, Icon Bioscience, Inc., Merck & Co., Inc., Sanwa Kagaku Kenkyusho Co., Ltd., and Novartis AG. Various clinical trials are being conducted to study the treatment options for cystoids macular edema. Several institutions contributing to these clinical trials across the globe are Johns Hopkins University, Wake Forest University, Iladevi Cataract and IOL Research Center, Rabin Medical Center, Hong Kong Eye Hospital, Kyushu University, Wills Eye Institute, Retina Institute of Hawaii, University of Bern, Queen’s University and Tabriz University.