&lt;p&gt;Macular edema associated with non-infectious uveitis: pathophysiology, etiology, prevalence, impact and management challenges&lt;/p&gt;

Massa, Horace; Pipis, Spyros Y; Adewoyin, T.; Vergados, Athanasios; Patra, Sudeshna; Panos, Georgios D

doi:10.2147/opth.s180580

Cited by 46 publications

(65 citation statements)

References 182 publications

(176 reference statements)

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“…Intermediate uveitis is the least common type of uveitis; but, with the highest frequency of ME within the range of 25% to 70%. ME rate in posterior uveitis is 19-34% and in panuveitis is 18-66% [23]. In non-infectious uveitis, ME is the most common complication, as it occurs in 8.3% of patients, followed by epiretinal membrane 6.3% and glaucoma 4.2% [24].…”

Section: Macular Edema Associated With Uveitismentioning

confidence: 99%

Review on the Role of Macular Edema in Retinopathy, Blindness and Automated Diagnosis Methods

Barman¹,

Deb²,

Hassan³

et al. 2021

EAI Endorsed Trans Perv Health Tech

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INTRODUCTION: Macular edema is not a disease itself, but, a very common condition in most of the retinal diseases, such as diabetic retinopathy, retinal vein occlusion, hypertensive retinopathy, age-related macular edema, etc. and postocular surgery. OBJECTIVES: We have discussed how macular edema plays an important role in blindness in case of various retinal blood vascular diseases and post-ophthalmic surgery. We have analyzed vast state-of-the-art methods for retinal abnormality detection. METHODS: The proposed method uses a semi-automated macula segmentation approach and Local Binary Pattern features to train k-Nearest Neighbor classifier and performs binary classification. RESULTS: We have achieved 80% accuracy and 90% sensitivity in classifying normal and abnormal retina CONCLUSION: We justified the notion that it will be beneficial to have a method that can analyse the macula region and alert if there is any abnormality near that region to prevent vision loss.

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Section: Macular Edema Associated With Uveitismentioning

confidence: 99%

Review on the Role of Macular Edema in Retinopathy, Blindness and Automated Diagnosis Methods

Barman¹,

Deb²,

Hassan³

et al. 2021

EAI Endorsed Trans Perv Health Tech

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“…Thirty-four percent of children with uveitis present with at least one ocular complication at the time of diagnosis and 86.3% have ocular complications by 3 years after diagnosis [1]. These complications, such as cataracts, glaucoma, posterior synechiae and macular edema, often lead to irreversible structural damage and significant visual disability [1,4].…”

Section: Introductionmentioning

confidence: 99%

Clinical outcomes of pediatric macular edema associated with non-infectious uveitis

Nguyen

Mekonnen

Kim

et al. 2021

J Ophthal Inflamm Infect

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Background Macular edema (ME) is the most frequent cause of irreversible visual impairment in patients with uveitis. To date, little data exists about the clinical course of ME in pediatric patients. A retrospective, observational study was performed to examine the visual and macular thickness outcomes of ME associated with chronic, noninfectious uveitis in pediatric patients. Methods Pediatric patients with noninfectious uveitis complicated by ME seen in the University of California San Francisco Health System from 2012 to 2018 were identified using ICD-9 and ICD-10 codes. Data were collected from medical records including demographics, diagnoses, ocular history, OCT imaging findings, complications, and treatments at first encounter and at 3, 6, 9, and 12-month follow-up visits. Cox proportional hazards regression was used to investigate the association between different classes of treatment (steroid drops, steroid injections, oral steroids and other immunosuppressive therapies) and resolution of macular edema. Results The cohort comprised of 21 children (26 eyes) with a mean age of 10.5 years (SD 3.3). Undifferentiated uveitis was the most common diagnosis, affecting 19 eyes (73.1%). The majority of observed macular edema was unilateral (16 patients, 76.2%) and 5 patients had bilateral macular edema. The mean duration of follow-up at UCSF was 35.3 months (SD 25.7). By 12 months, 18 eyes (69.2%) had achieved resolution of ME. The median time to resolution was 3 months (IQR 3–6 months). Median best-corrected visual acuity (BCVA) at baseline was 0.54 logMAR (Snellen 20/69, IQR 20/40 to 20/200). Median BCVA at 12 months was 0.1 logMAR (Snellen 20/25, IQR 20/20 to 20/50) Corticosteroid injections were associated with a 4.0-fold higher rate of macular edema resolution (95% CI 1.3–12.2, P = 0.01). Conclusions Although only 15% of the pediatric patients with uveitis in the study cohort had ME, it is clinically important to conduct OCTs to detect ME in this population. Treatment resulted in 69% of eyes achieving resolution of ME by 12 months, accompanied with improvement in visual acuity. Corticosteroid injections were significantly associated with resolution of macular edema.

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“…Non-infectious uveitis (NIU) is reported to have affected more than 298.000 adults (estimated prevalence 121/100.000) and more than 21.000 children (estimated prevalence 29/100.000) in the United States in 2015 [1,2]. Audrey et al [3] reported that NIU represents the fifth leading cause of visual impairment and it is accountable for about 10%-15% of legal blindness in middle-aged patients, predominantly between 20 and 50 years of age in developed countries [4][5][6] and up to 25% in the developing world [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Intraocular Inflammation Control and Changes in Retinal and Choroidal Architecture in Refractory Non-Infectious Uveitis Patients after Adalimumab Therapy

Pirani

Pelliccioni

Turris

et al. 2020

JCM

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Background: Non-infectious uveitis represents a leading cause of visual impairment, and inflammation control represents a major priority in tackling visual acuity loss due to complications such as macular edema; different immunomodulatory drugs are currently being used, including anti-TNF-alpha Adalimumab. Methods: This was a monocentric observational study of 18 eyes of 18 patients with non-infectious uveitis treated with Adalimumab. The primary endpoint was the control of ocular inflammation. The secondary endpoints included the study of macular and choroidal thickness and architecture, visual acuity, changes in other treatments, and adverse effects. Results: Ocular inflammation was controlled at 12 months for 83.3% of patients. Central macular thickness improved from a median of 229.75 µm at baseline to 213 µm at 12 months, while choroidal thickness decreased by 11.54% at the end of the follow-up. A reduction of vasculitis on fluorescein angiography and of hyperreflective spots on optical coherence tomography was noted. Visual acuity also improved from 0.51 (logMAR) before treatment to 0.24 at more than 12 months (p = 0.01). A total of 11.1% of patients experienced side effects. Conclusion: Our study confirms the efficacy of adalimumab for the control of ocular inflammation, visual acuity preservation, and for corticosteroid sparing.

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<p>Macular edema associated with non-infectious uveitis: pathophysiology, etiology, prevalence, impact and management challenges</p>

Cited by 46 publications

References 182 publications

Review on the Role of Macular Edema in Retinopathy, Blindness and Automated Diagnosis Methods

Review on the Role of Macular Edema in Retinopathy, Blindness and Automated Diagnosis Methods

Clinical outcomes of pediatric macular edema associated with non-infectious uveitis

Intraocular Inflammation Control and Changes in Retinal and Choroidal Architecture in Refractory Non-Infectious Uveitis Patients after Adalimumab Therapy

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