The current standard of care for macular edema is intravitreal injection. During this painless procedure, numbing drops are applied to the eye, and a short thin needle is used to inject medication into the vitreous gel (the fluid in the center of the eye). The drugs used in this treatment –Avastin, Eylea, and Lucentis – block the activity of a substance called vascular endothelial growth factor (VEGF). VEGF promotes blood vessel growth. In a healthy eye, this is not a problem. But in some conditions, the retina becomes starved for blood and VEGF becomes overactive. This causes the growth of fragile blood vessels which can rupture and leak blood into the retina and macula, causing macular edema. Anti-VEGF treatment blocks the activity of VEGF and slows the progress of macular edema.
When malignant intraocular tumors are associated with CME, the priority is to treat the tumor. Systemic malignancies, such as multiple myeloma, have been observed to be associated with CME. Systemic treatment of the myeloma is the priority and usually addresses the CME. However, sub-Tenon injection of steroid may enhance resolution of the CME in such cases. Depending on the nature of the disease, CME associated with intraocular tumors requires treatment of the tumor (eg, laser photocoagulation, cryotherapy, radiation, thermotherapy, enucleation).