Cystoid macular edema responds to intravitreal triamcinolone and rebounds after intravitreal bevacizumab

A 63-year-old man with decreased vision due to post-surgical chronic cystoid macular edema that was recalcitrant to topical nonsteroidal anti-inflammatory drops had resolution of cystoid macular edema after intravitreal triamcinolone injection. However, 3 months later he developed increased intraocular pressure and a recurrence of the cystoid macular edema. Intravitreal bevacizumab was administered and optical coherence tomography revealed worsening of the cystoid macular edema 1 month after the injection. Chronic cystoid macular edema that does not respond to topical nonsteroidal anti-inflammatory drops may resolve with intravitreal triamcinolone but not with bevacizumab. The current case demonstrates that some cystoid macular edema may not be responsive to vascular endothelial growth factor blockade alone. Further studies are needed to evaluate the pathogenesis of cystoid macular edema and determine whether vascular endothelial growth factor blockade should be included in treatment modalities for this condition.