Flashcards on Retinal Vascular Diseases: Pathophysiology and Management

Retinal Vascular Diseases: Pathophysiology & Management Guide

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What is the general role of steroids in treating diabetic macular oedema (DME)?

Steroids are used as treatment for DME, often as second-line agents due to side effects (cataract progression, elevated IOP); they may be combined wit

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Diabetic macular edema

37 cards

Card 1

Question: What is the general role of steroids in treating diabetic macular oedema (DME)?

Answer: Steroids are used as treatment for DME, often as second-line agents due to side effects (cataract progression, elevated IOP); they may be combined wit

Card 2

Question: Name two routes of triamcinolone delivery mentioned for DME.

Answer: Intravitreal and sub-Tenon (subtenon) injections of triamcinolone acetonide.

Card 3

Question: When might combining laser with intravitreal triamcinolone be beneficial?

Answer: For diffuse/extensive macular edema.

Card 4

Question: Why are steroids generally considered second-line agents for DME, especially in phakic patients?

Answer: Because of side effects including cataract progression and elevated intraocular pressure (IOP).

Card 5

Question: What is suprachoroidal triamcinolone and give the example product mentioned?

Answer: A formulation of triamcinolone for suprachoroidal delivery; example: SCS-TA (Xipere®, Bausch + Lomb) delivered via the SCS Microinjector® (Clearside).

Card 6

Question: Which intravitreal steroid implants are approved for DME according to the content?

Answer: Dexamethasone implant (Ozurdex, Allergan) and 0.19 mg fluocinolone implant (Iluvien, Alimera Sciences).

Card 7

Question: What is the recommended approach for non–center-involved macular edema?

Answer: Observation or photocoagulation.

Card 8

Question: What is the recommended treatment for center-involved macular edema?

Answer: Anti-VEGF therapy, with steroids as a possible adjunct (but steroids increase risk of elevated IOP).

Card 9

Question: List two main adverse effects of intravitreal steroids relevant to DME management.

Answer: Cataract progression and elevated intraocular pressure (IOP).

Card 10

Question: For what type of DME might an intravitreal steroid be favored despite risks?

Answer: Extensive or diffuse DME where combining with laser may be beneficial; or when anti-VEGF is unsuitable or ineffective (implied by second-line use).