Abstract
Uveitis related macular edema constitutes a common complication for up to 8.3% of uveitis patients and is a leading cause of serious visual impairment in about 40% of cases. Despite rigorous treatment with steroids and other immunomodulators, at least a third of patients fail to achieve satisfactory improvement in visual acuity, due to drug intolerance or ineffectiveness, thus requiring addition of other therapeutic approaches.Recent advances in the vitreoretinal surgery have expanded the indications of vitrectomy in a broad spectrum of diseases including uveitis macular edema. Research studies have investigated the efficacy and safety of pars plana vitrectomy (PPV) in addressing cystoid macular edema (CME) associated with chronic uveitis. Primary outcomes investigate changes in visual acuity and angiographic appearance of CME over a specified period post‐surgery.According to a randomized, controlled pilot study, PPV resulted in significant improvement in terms of visual acuity, with a notable percentage of eyes achieving vision of 20/40 or better. An additional retrospective study highlighted the effectiveness of PPV without macular intervention in terms of reducing intraocular inflammation and resolving macular edema in uveitis eyes, leading to improved best‐corrected visual acuity and reduced reliance on systemic steroids and immunosuppressives. The findings suggest that PPV can be a safe and effective approach for managing persistent vitreous inflammation and opacities in uveitis patients, contributing to improved visual acuity, reduced inflammation, and resolution of macular edema. Despite limitations regarding small sample sizes and retrospective designs, these studies provide valuable insights into the potential role of vitrectomy in enhancing visual outcomes and controlling inflammation in uveitis eyes.In conclusion, PPV should be considered as o noble option for the management of CME in uveitis patient, for its positive impact on Visual function and inflammatory control.
Published Version
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