Drugs Causing Cystoid Macular Edema: Pathogenesis, Diagnosis, and Treatment

Cystoid macular edema (CME) is a disorder that usually develops in association with ocular pathologies or systemic diseases. Various topical or systemic drugs are also known to lead to the formation of cystoid macular edema. Anti-hyperlipidemic drug niacin (nicotinic acid), antineoplastic agents taxanes (paclitaxel/docetaxel), oral antidiabetic drugs glitazones, iron, and aluminum chelator deferoxamine, and fingolimod used in the treatment of multiple sclerosis are drugs used systemically and shown to be associated with macular edema. In addition, epinephrine and prostaglandin analogs are ocular agents known to be associated with CME. The purpose of this article is to provide an overview of the available scientific evidence on the development of drug-induced cystoid macular edema and to provide insight into possible pathophysiological mechanisms and therapeutic approaches.