Abstract
Uveitic macular edema (ME) is a frequent complication in 8.3% of uveitis patients and is a leading cause of serious visual impairment in about 40% of cases. Despite the numerous available drugs for its treatment, at least a third of patients fail to achieve satisfactory improvement in visual acuity. First-line drugs are steroids administered by various routes, but drug intolerance or ineffectiveness occur frequently, requiring the addition of other groups of therapeutic drugs. Immunomodulatory and biological drugs can have positive effects on inflammation and often on the accompanying ME, but most uveitic randomized clinical trials to date have not aimed to reduce ME; hence, there is no clear scientific evidence of their effectiveness in this regard. Before starting therapy to reduce general or local immunity, infectious causes of inflammation should be ruled out. This paper discusses local and systemic drugs, including steroids, biological drugs, immunomodulators, VEGF inhibitors, and anti-infection medication.
Highlights
Uveitis is a common cause of blindness, especially at working age and in low- or middle-income countries [1,2]
19 randomized clinical trials of immunomodulating drugs for intermediate and posterior uveitis could be found in the medical databases, but these studies did not always present macular edema (ME) data, or the researchers observed positive trends toward reducing macular thickness but without statistical significance [49]
The results suggested that tumor necrosis factor inhibitors could increase mortality, but this was not evident in patients treated with azathioprine, methotrexate, mycophenolate mofetil, ciclosporin, systemic corticosteroids, or dapsone [52]
Summary
Uveitis is a common cause of blindness, especially at working age and in low- or middle-income countries [1,2]. There are many causes of blindness or significant visual impairment in patients with uveitis, but the most common and important is macular edema (ME), which affects about 40% of patients with 20/60 visual acuity or less, according to [3]. ME occurs in 8.3% of non-infectious uveitis patients [4]. It can persist without any sign of concurrent inflammation, but active inflammation can make ME difficult to treat. Proper uveitis management that considers the etiology in a specific case is sometimes enough to restore normal retinal thickness, but many patients require additional treatment dedicated to ME. Long-term treatment, should avoid the use of steroid drugs because of their common side effects
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
