Uveitic macular edema

Fardeau, Christine; Champion, Emmanuelle; Massamba, Nathalie; LeHoang, Phuc

doi:10.1038/eye.2016.115

Cited by 116 publications

(73 citation statements)

References 85 publications

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“…Uveitic CME is thought to result from increased vascular permeability due to the breakdown of BRB and is a major risk factor for vision loss (Fardeau et al. ; Goldhardt & Rosen ) and often difficult to manage (Androudi et al. ; Fardeau et al.…”

Section: Discussionmentioning

confidence: 99%

“…In Androudi et al (2010), intravitreal adalimumab showed no efficacy in improving BCVA or decreasing CMT; however, it should be noted that in this particular study, all patients had refractory CME at baseline. Uveitic CME is thought to result from increased vascular permeability due to the breakdown of BRB and is a major risk factor for vision loss (Fardeau et al 2015;Goldhardt & Rosen 2016) and often difficult to manage (Androudi et al 2010;Fardeau et al 2015;Deuter et al 2016;Goldhardt & Rosen 2016). As longstanding CME will result in irreversible damage to as a result of outer retinal and photoreceptor damage, anatomical resolution of the CME will not lead to improvement in BCVA (Androudi et al 2010).…”

Section: Summary Of Evidencementioning

confidence: 99%

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Efficacy and safety of intravitreal anti‐tumour necrosis factor drugs in adults with non‐infectious uveitis – a systematic review

Leal

Rodrigues

Sousa

et al. 2018

Acta Ophthalmologica

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Anti-tumour necrosis factor (TNF) drugs have been extensively used in non-infectious uveitis (NIU), when corticosteroids or conventional immunosuppressive drugs cannot adequately control inflammation or intolerable side-effects occur. However, systemic anti-TNF therapies are also associated with a myriad of side-effects. Therefore, intravitreal administration of anti-TNF biologics has been employed to minimize patient morbidity and systemic adverse effects, while maintaining therapeutic effectivity. We undertook a systematic review to determine evidence of efficacy and safety of intravitreal administration of anti-TNF drugs in adults with NIU. We conducted this systematic review according to the PRISMA guidelines. The protocol was registered with PROSPERO (CRD42016041946). We searched CENTRAL, MEDLINE and EMBASE, from inception to April 2017, as well as clinical trial registries and grey literature. The qualitative analysis included all studies of adult patients with a diagnosis of NIU and who received intravitreal anti-TNF drugs with a 4-week minimum follow-up. A total of 4840 references were considered for title and abstract screening. Seven full texts were screened, and five studies were considered for analysis. All studies were open-label, single-centre, prospective, non-randomized, interventional case series with a follow-up between 4 and 26 weeks, employing either adalimumab in two studies and infliximab in three. Three studies showed a treatment effect of anti-TNF intravitreal injections, while one study revealed short-term improvement and one study revealed no efficacy of anti-TNF intravitreal therapy. None of the studies reported ocular adverse effects but only two studies included electrophysiological assessment in the safety analysis and no study assessed systemic human anti-drug antibodies. The available evidence is not sufficiently robust to conclude about the clinical effectivity of intravitreal anti-TNF in NIU and so no recommendation can be made. In conclusion, intravitreal injection of anti-TNF antibodies remains a possible treatment option to be explored through robust clinical investigation.

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Section: Discussionmentioning

confidence: 99%

Section: Summary Of Evidencementioning

confidence: 99%

Efficacy and safety of intravitreal anti‐tumour necrosis factor drugs in adults with non‐infectious uveitis – a systematic review

Leal

Rodrigues

Sousa

et al. 2018

Acta Ophthalmologica

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“…More than 30% patients with uveitis can develop serious sight-threatening vision loss due to UME. [1][2][3] The prevalence of UME is more common with posterior uveitis. However, any form of inflammation in the eye, including anterior uveitis (AU), can lead to UME.…”

mentioning

confidence: 99%

Disease of the Year: Differential Diagnosis of Uveitic Macular Edema

Agarwal

Pichi

Invernizzi

et al. 2018

Ocular Immunology and Inflammation

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Uveitic cystoid macular edema (UME) is an important cause of visual morbidity among patients with both infectious and non-infectious uveitis. UME may be associated in more than 30% cases of active uveitis. However, even patients with minimal features of intraocular inflammation may develop recurrent or chronic UME. Therefore, the evaluation and management of UME in patients with uveitis may be challenging. A number of vitreoretinal pathologies may result in UME and accumulation of fluid in the intra-or subretinal space. These need to be carefully distinguished from each other so that appropriate management can be initiated. All types of uveitis, including anterior uveitis (where the primary site of inflammation is not in the posterior segment) can present with UME. Other conditions such as diabetes, and surgery, can present with macular edema. This index review highlights various differential diagnoses of UME and provides illustrative case examples with multimodal imaging evaluation.

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“…Cystoids are fluid accumulation in cyst-like spaces in the outer plexiform layer of the macula. Cystoid Macular Edema (CME) complicates the course of many ocular disorders such as uveitis, diabetic retinopathy, retinal vein occlusion, retinitis pigmentosa, radiation retinopathy and may also complicate intraocular surgery [1,2]. Inflammatory macular edema can occur in anterior, intermediate or posterior uveitis.…”

Section: Introductionmentioning

confidence: 99%

“…Inflammatory macular edema can occur in anterior, intermediate or posterior uveitis. Uveitis can have varied etiologies including infections, tumors, autoimmunity or idiopathic causes [2]. It typically presents as an active, chronic inflammation and may eventually develop an epiretinal membrane.…”

Section: Introductionmentioning

confidence: 99%