Devising treatment strategies for uveitic macular edema (UME) is challenging because the UME can persist even when the uveitic inflammation has been controlled by immunosuppressive agents. Increasing systemic immunosuppressive treatment may not lead to improvement of edema, and adjunctive therapy, often with corticosteroids, is frequently needed. Published reports describe various agents for UME, but there is no consensus as to which treatments are preferred. A Medline search was performed for clinical studies of the treatment of UME, and the Web site www.clinicaltrials.gov was consulted to see if there were relevant clinical trials. This article highlights results from those searches. The evidence level is overall low (usually level 2 or 3) for the treatment of macular edema in uveitis. Most studies showed no more than slight benefit to treatment possibly because visual improvement was limited by damage from prior edema. A variety of corticosteroids and various routes of administration have been studied. More recently biologic agents and other immunomodulatory drugs have been employed. Improved study designs with randomization, sufficient sample size, and follow-up are necessary to define the optimal management of UME. Outcome measures of standardized visual acuity using Early Treatment Diabetic Retinopathy Study charts and optical coherence tomography parameters will provide additional information on structure and function beyond the standard assessment of fluo-rescein leakage.
|Original language||English (US)|
|Number of pages||7|
|Journal||Johns Hopkins Advanced Studies in Ophthalmology|
|State||Published - Dec 1 2010|
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