Uveitic macular edema (UME) is one of the most common causes of significant visual impairment in patients with uveitis and its management can be challenging. The purpose of this study is to report treatment options and clinical outcomes in patients with UME in a tertiary center.
Retrospective review of patient’s medical records with a regular follow-up in a Uveitis Clinic, diagnosed with UME. Best-corrected visual acuity (BCVA) and Central foveal thickness (CFT) were recorded before and after UME resolution.
Twenty-nine eyes of 23 patients were included. Etiologies of UME included idiopathic anterior uveitis (7, 30.4%), sarcoidosis (5, 21.7%), anterior uveitis HLA-B27+ (4, 17.4%), birdshot chorioretinopathy (2, 8.7%), Behçet’s disease (2, 8.7%), psoriatic arthritis (1, 4.3%) and pars planitis (1, 4.3%). None presented infectious UME. UME resolution was observed after dexamethasone intravitreal implant (IVI) in 9 (31,0%) eyes, fluocinolone acetonide IVI in 6 (20.7%), intravitreal triamcinolone in 2 (6.9%), topical NSAIDs in 2 (6.9%) and intravitreal VEGF inhibitors in 1 (3.4%). Isolated systemic treatment resolved 7 (24.1%) UME cases. BCVA improved significantly, from 0.40±0.23 logMAR before UME treatment to 0.15±0.16 at UME resolution. Additionally, CFT was reduced from 478.1±122.5μm to 283.0±41.1μm. Final BCVA and CFT were not different between patients treated with either IVI (p=0.854 and p=0.456). Sixteen eyes (55.2%) had at least 1 recurrence episode after the first treatment option.
UME is one of the main causes of visual morbidity in non-infectious uveitis and several treatment options are available. In our sample, patients treated with dexamethasone or fluocinolone acetonide IVI had similar clinical outcomes.