RETINAL TRYPSIN DIGEST STUDY OF CYSTOID MACULAR EDEMA ASSOCIATED WITHPERIPHERAL CHOROIDAL MELANOMA

PURPOSE: Although the association of cystoid macular edema with periph eral choroidal melano ma has been studied previously, the pathogenesis of cystoid macular edema as evaluated by light and electron microscop y remains controversial. We evaluated the cause of cystoid macular ede ma at the retinal capillary level. METHODS: We clinicopathologically c orrelated petaloidlike changes noted on fluorescein angiography with t he corresponding morphologic changes, as documented by retinal trypsin digest preparation. RESULTS: The angiographic foci of fluorescein lea kage were found to correspond to sites of endothelial cell proliferati on that resembled intraretinal microvascular abnormalities in the reti nal trypsin digest preparation. CONCLUSIONS: The source of cystoid mac ular edema at the level of the retinal capillary network are intrareti nal microvascular abnormalities resembling endothelial cell proliferat ion. We examine the relationship between endothelial cell proliferatio n and vascular leakage.