Efficacité de l’interféron alpha dans le traitement des œdèmes maculaires uvéitiques réfractaires au traitement corticoïde et/ou immunosupresseur

Paire, V.; Lebreton, Olivier; Weber, Michel

doi:10.1016/j.jfo.2010.01.008

Cited by 23 publications

(3 citation statements)

References 31 publications

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“…These included IFN-α-2A, intravitreal adalimumab, infliximab, mycophenolate, subcutaneous efalizumab, and etanercept 35,37–42,90,91. No RCTs have been published, with studies ranging from intervention prospective nonrandomized trials, case series, and retrospective reviews.…”

Section: Interventionsmentioning

confidence: 99%

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Interventions for the treatment of uveitic macular edema: a systematic review and meta-analysis

Karim¹,

Sykakis²,

Lightman³

et al. 2013

OPTH

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BackgroundUveitic macular edema is the major cause of reduced vision in eyes with uveitis.ObjectivesTo assess the effectiveness of interventions in the treatment of uveitic macular edema.Search strategyCochrane Central Register of Controlled Trials, Medline, and Embase. There were no language or data restrictions in the search for trials. The databases were last searched on December 1, 2011. Reference lists of included trials were searched. Archives of Ophthalmology, Ophthalmology, Retina, the British Journal of Ophthalmology, and the New England Journal of Medicine were searched for clinical trials and reviews.Selection criteriaParticipants of any age and sex with any type of uveitic macular edema were included. Early, chronic, refractory, or secondary uveitic macular edema were included. We included trials that compared any interventions of any dose and duration, including comparison with another treatment, sham treatment, or no treatment.Data collection and analysisBest-corrected visual acuity and central macular thickness were the primary outcome measures. Secondary outcome data including adverse effects were collected.ConclusionMore results from randomized controlled trials with long follow-up periods are needed for interventions for uveitic macular edema to assist in determining the overall long-term benefit of different treatments. The only intervention with sufficiently robust randomized controlled trials for a meta-analysis was acetazolamide, which was shown to be ineffective in improving vision in eyes with uveitic macular edema, and is clinically now rarely used. Interventions showing promise in this disease include dexamethasone implants, immunomodulatory drugs and anti-vascular endothelial growth-factor agents. When macular edema has become refractory after multiple interventions, pars plana vitrectomy could be considered. The disease pathophysiology is uncertain and the course of disease unpredictable. As there are no clear guidelines from the literature, interventions should be tailored to the individual patient.

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Section: Interventionsmentioning

confidence: 99%

“…IFNs influence both innate and adaptive immune responses and play a role in the defense against viral infections and tumor growth. In autoimmune diseases, IFNs appear as double agents, involved in both supportive and suppressive action 38–42…”

Section: Introductionmentioning

confidence: 99%

Interventions for the treatment of uveitic macular edema: a systematic review and meta-analysis

Karim¹,

Sykakis²,

Lightman³

et al. 2013

OPTH

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“…Today, many treatment options are available and include systemic steroids, immunosuppressive treatments with steroid sparing characteristics, systemic biotherapies and local treatments including mainly intravitreal dexamethasone (DEXi; Ozurdex ® ; Abbvie, Chicago, IL, USA) and fluocinolone acetonide (FA) implants (FAi). Systemic corticosteroids are highly efficient but cause metabolic and organ-specific complications that are poorly tolerated in the long term [ 3 , 4 , 5 , 6 ]. The advent of corticosteroid-sparing agents and biotherapies has dramatically decreased the treatment burden of corticosteroids; however, these drugs can come with their own complications.…”

Section: Introductionmentioning

confidence: 99%

Efficacity and Safety of the Fluocinolone Acetonide Implant in Uveitic Macular Edema: A Real-Life Study from the French Uveitis Network

Jabbour,

Kodjikian,

Bourdin

et al. 2024

JPM

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Purpose: To evaluate the safety and efficacy of the fluocinolone acetonide implant (FAi, Iluvien® Horus pharma, Nice, France) in non-infectious uveitic macular edema (UME) and to approach the predictive factors of treatment response. Methods: This retrospective, multicenter real-life study included patients with chronic non-infectious UME who received intravitreal FAi after at least two dexamethasone implants (DEXi). Results: Twenty-six eyes from 22 patients (73.1% of females) were included. The mean age was 60.4 ± 16 years. The mean follow-up was 11.4 ± 2 months. The mean baseline best-corrected visual acuity (BCVA) was 0.43 ± 0.36 LogMAR, improving significantly after 1, 3, 6 and 12 months (all p < 0.05 vs. baseline). The mean baseline central macular thickness (CMT) was 429 ± 110 μm, improving significantly after 1, 3, 6 and 12 months (all p < 0.05 vs. baseline). Five eyes (19.2%) developed ocular hypertension during the follow-up, requiring initiation or strengthening of intraocular pressure lowering medication. The majority of eyes (77%) did not require any rescue DEXi during the available 12-month follow-up. The resolution of UME after DEXi seemed to predict the anatomical response after FAi. The baseline presence of a disorganization of the inner retinal layers (DRIL) and hyperreflective foci (HRF) were both associated with a higher likelihood of requiring rescue DEXi injections. Conclusion: FAi implantation led to a significant BCVA and CMT improvement with a good safety profile over the 12-month follow-up. Predictive factors of treatment outcomes seem to include the anatomical response to DEXi and the presence of DRIL and HRF at baseline.

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Interferons and Intravenous Immunoglobulin

Borkar

Butler

2019

Treatment of Non-Infectious Uveitis

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Efficacité de l’interféron alpha dans le traitement des œdèmes maculaires uvéitiques réfractaires au traitement corticoïde et/ou immunosupresseur

Cited by 23 publications

References 31 publications

Interventions for the treatment of uveitic macular edema: a systematic review and meta-analysis

Interventions for the treatment of uveitic macular edema: a systematic review and meta-analysis

Efficacity and Safety of the Fluocinolone Acetonide Implant in Uveitic Macular Edema: A Real-Life Study from the French Uveitis Network

Interferons and Intravenous Immunoglobulin

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