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Uveitic macular edema

Eye (London), 2016-10, Vol.30 (10), p.1277-1292 [Peer Reviewed Journal]

Copyright Nature Publishing Group Oct 2016 ;Copyright © 2016 Royal College of Ophthalmologists 2016 Royal College of Ophthalmologists ;ISSN: 0950-222X ;EISSN: 1476-5454 ;DOI: 10.1038/eye.2016.115 ;PMID: 27256304

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  • Title:
    Uveitic macular edema
  • Author: Fardeau, C ; Champion, E ; Massamba, N ; LeHoang, P
  • Subjects: Fluorescein Angiography ; Glucocorticoids - therapeutic use ; Humans ; Immunosuppressive Agents - therapeutic use ; Macular Edema - diagnosis ; Macular Edema - drug therapy ; Macular Edema - etiology ; Macular Edema - physiopathology ; Review ; Risk Factors ; Tomography, Optical Coherence ; Uveitis - complications ; Uveitis - diagnosis ; Uveitis - drug therapy ; Uveitis - physiopathology ; Vision Disorders - etiology
  • Is Part Of: Eye (London), 2016-10, Vol.30 (10), p.1277-1292
  • Description: Macular edema (ME) may complicate anterior, intermediate, and posterior uveitis, which may be because of various infectious, neoplastic or autoimmune etiologies. BRB breakdown is involved in the pathogenesis of Uveitic ME (UME). Optical coherence tomography has become a standard tool to confirm the diagnosis of macular thickening, due to its non-invasive, reproducible, and sensitive features. Retinal fluorescein and indocyanine green angiography is helpful to study the macula and screen for associated vasculitis, detect ischemic areas and preretinal, prepapillary or choroidal neovascular complications, and it may provide information about the etiology and be needed to assess the therapeutic response. UME due to an infection or neoplastic infiltration may require a specific treatment. If it remains persistent or occurs in other etiologies, immunomodulatory treatments may be needed. Intravitreal, subconjunctival, or subtenon corticosteroids are widely used. Their local use is contraindicated in glaucoma patients and limited by their short-lasting action. In case of bilateral sight-threatening chronic posterior uveitis, systemic treatments are usually needed, and corticosteroids are used as the standard first-line therapy. In order to reduce the daily steroid dose, immunosuppressive or immunomodulatory agents may be added, some of them being now available intravitreally. Ongoing prospective studies are assessing biotherapies and immunomodulators to determine their safety and efficacy in this indication.
  • Publisher: England: Nature Publishing Group
  • Language: English
  • Identifier: ISSN: 0950-222X
    EISSN: 1476-5454
    DOI: 10.1038/eye.2016.115
    PMID: 27256304
  • Source: Open Access: PubMed Central
    AUTh Library subscriptions: ProQuest Central
    MEDLINE
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