Medical treatment of macular edema in patients with uveitis.
OBJECTIVE
To determine the efficacy of medical treatment of cystoid macular edema (CME) in patients with uveitis.


METHODS
Retrospective study of 40 patients (57 eyes) with uveitis and CME. Inclusion criteria were presence of CME with minimal and no macular pathology, or vascular disease which could account for CME. Patients who had undergone intraocular surgery or had visual acuity (VA) of > or = 20/40 were excluded. The diagnosis of CME was based on clinical and/or angiographic findings. Three treatment groups were defined: (1) transseptal injection of steroids (n=13 eyes); (2) systemic non steroidal anti-inflammatory drugs (NSAIDs) (n=11 eyes); both 1 and 2 (n=33 eyes).


RESULTS
Overall, 79% of eyes improved 3 or more lines of Snellen VA after treatment: 51% improved 4 or more lines. The average number of lines improved was 3.8 for eyes treated with transseptal injections of steroids, 2.9 for eyes treated with NSAIDs, and 4 for eyes treated with both. For all 3 treatment groups between 60-70% of eyes improving 2 or more lines reached best VA only after a minimum of 6 months of follow up.


CONCLUSIONS
CME, a vision threatening complication of uveitis, respond fairly well to medical treatment; however, the best VA is achieved after several months. The improvement in VA did not differ markedly among the three treatment groups.
Rojas
B
B
Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, MA 02114, USA.
Zafirakis
P
P
Christen
W
W
Markomichelakis
N N
NN
Foster
C S
CS
D000293:Adolescent; D000328:Adult; D000368:Aged; D000867:Anterior Chamber / Q000473:pathology; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use*; D002257:Carbonic Anhydrase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D002648:Child; D004333:Drug Administration Routes; D004359:Drug Therapy, Combination; D005260:Female; D005451:Fluorescein Angiography; D005654:Fundus Oculi; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D008266:Macula Lutea / Q000473:pathology; D008269:Macular Edema / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D014606:Uveitis, Anterior / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D015867:Uveitis, Intermediate / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D015866:Uveitis, Posterior / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D014792:Visual Acuity; D014822:Vitreous Body / Q000473:pathology
D000894:Anti-Inflammatory Agents, Non-Steroidal; D002257:Carbonic Anhydrase Inhibitors; D005938:Glucocorticoids