Does Choroidal Thickness Matter In Clinically Significant Pseudophakic Cystoid Macular Edema?

To evaluate subfoveal choroidal thickness (SCT) in eyes with clinically significant pseudophakic cystoid macular edema (PCME) and compare it with the contralateral pseudophakic eyes that underwent uncomplicated cataract surgery within a similar postoperative period using enhanced depth imaging optical coherence tomography (EDI-OCT).

Tertiary referral center, Department of Ophthalmology, Sakarya University Medical Education and Research Hospital, Turkey.

This retrospective observational study included 25 patients with clinically significant PCME following uneventful phacoemulsification and posterior chamber intraocular lens implantation. The control group consisted of contralateral pseudophakic eyes that had undergone uncomplicated cataract surgery within one month of the affected eye and did not develop PCME. SCT and central macular thickness (CMT) were measured using spectral-domain OCT with EDI mode. Best-corrected visual acuity (BCVA), age, and sex were recorded. Paired comparisons were performed between PCME eyes and pseudophakic fellow eyes to minimize the confounding effect of surgery-related choroidal changes.

The mean age of the patients was 66.13 ± 5.44 years (range, 59–77). 14 (56%) were male and 11 (44%) were female. The mean interval between cataract surgery and PCME diagnosis was 6.2 ± 1.6 weeks. The mean CMT was significantly higher in PCME eyes (458.20 ± 92.30 µm) compared with pseudophakic fellow eyes (235.66 ± 28.43 µm, p < 0.001). The mean SCT was 297.27 ± 24.52 µm in PCME eyes and 289.41 ± 22.16 µm in pseudophakic fellow eyes. Although SCT was numerically greater in PCME eyes, the difference did not reach statistical significance (p = 0.18).

SCT was slightly higher in eyes with PCME compared to contralateral pseudophakic eyes operated within a similar postoperative period; however, the difference was not statistically significant. These findings suggest that choroidal thickening observed in PCME may largely reflect postoperative inflammatory changes rather than a disease-specific choroidal mechanism.