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Update in treatment of uveitic macular edema

Drug design, development and therapy, 2019-01, Vol.13, p.667-680 [Peer Reviewed Journal]

COPYRIGHT 2019 Dove Medical Press Limited ;2019. This work is licensed under https://creativecommons.org/licenses/by-nc/3.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. ;2019 Koronis et al. This work is published and licensed by Dove Medical Press Limited 2019 ;ISSN: 1177-8881 ;EISSN: 1177-8881 ;DOI: 10.2147/DDDT.S166092 ;PMID: 30858697

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Title:
Update in treatment of uveitic macular edema
Author: Koronis, Spyridon ; Stavrakas, Panagiotis ; Balidis, Miltiadis ; Kozeis, Nikolaos ; Tranos, Paris G
Subjects: Adalimumab ; Anti-inflammatory agents ; Anticancer properties ; Azathioprine ; Care and treatment ; Cataracts ; Controlled release ; Corticoids ; Corticosteroids ; Cyclosporins ; Dexamethasone ; Difluprednate ; Disease ; Dropsy ; Edema ; Fluocinolone ; Fluocinolone acetonide ; Immunomodulation ; Immunomodulators ; Implants ; Inflammation ; Infliximab ; Interferon ; Medical imaging ; Methotrexate ; Monoclonal antibodies ; Mycophenolate mofetil ; Mycophenolic acid ; Nonsteroidal anti-inflammatory drugs ; Review ; Rheumatoid arthritis ; Sarcoidosis ; Steroid hormones ; Steroids ; Sustained release ; Tacrolimus ; Tapering ; treatment ; Tumor necrosis factor-TNF ; Tumor necrosis factor-α ; uveitic macular edema ; Uveitis
Is Part Of: Drug design, development and therapy, 2019-01, Vol.13, p.667-680
Description: Macular edema (ME) represents the most common cause for visual loss among uveitis patients. The management of uveitic macular edema (UME) may be challenging, due to its often recalcitrant nature. Corticosteroids remain the mainstay of treatment, through their capability of effectively controlling inflammation and the associated ME. Topical steroids may be effective in milder cases of UME, particularly in edema associated with anterior uveitis. Posterior sub-Tenon and orbital floor steroids, as well as intravitreal steroids often induce rapid regression of UME, although this may be followed by recurrence of the pathology. Intra-vitreal corticosteroid implants provide sustained release of steroids facilitating regression of ME with less frequent injections. Topical nonsteroidal anti-inflammatory drugs may provide a safe alternative or adjuvant therapy to topical steroids in mild UME, predominantly in cases with underlying anterior uveitis. Immunomodulators including methotrexate, mycophenolate mofetil, tacrolimus, azathioprine, and cyclosporine, as well as biologic agents, notably the anti-tumor necrosis factor-α monoclonal antibodies adalimumab and infliximab, may accomplish the control of inflammation and associated ME in refractory cases, or enable the tapering of steroids. Newer biotherapies have demonstrated promising outcomes and may be considered in persisting cases of UME.
Publisher: New Zealand: Dove Medical Press Limited
Language: English
Identifier: ISSN: 1177-8881
EISSN: 1177-8881
DOI: 10.2147/DDDT.S166092
PMID: 30858697
Source: GFMER Free Medical Journals
PubMed Central
DOVE Medical Press Journals
ROAD: Directory of Open Access Scholarly Resources
ProQuest Central
DOAJ Directory of Open Access Journals

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Update in treatment of uveitic macular edema

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