title: Treatment and functional outcome of patients with cystoid macular edema: a single-center experience.
abstract: The aim of this study was to describe a single-center experience in the treatment and follow-up of cystoid macular edema patients. Clinical records of all patients with cystoid macular edema followed up in the Rheumatologic and Ophthalmological Unit of our center between 1993 and 2013 were retrospectively evaluated. The outcome was assessed by visual acuity and optical coherence tomography status during follow-up. Comparisons were made by Fisher's exact test (p < 0.05 significant). In this study 16 eyes in 9 patients were analyzed. Our study includes mainly post-uveitic (78 %) cases with a high prevalence of human leukocyte antigen B51 (67 %). Systemic immunosuppressive therapy was prescribed in 87 % of cases. The most frequently used drugs were cyclosporine, interferon-α, and infliximab. The first two molecules appeared respectively the most used as the first option and the one with the longest survival on treatment. Interferon-α was the most effective drug in contrasting visual acuity loss compared to the majority of drugs, but significantly more effective than mycophenolate (p = 0.01) in reducing macular edema. At the end of follow-up, 50 % of patients showed a significant visual loss, while 88 % did not present macular edema. In our small cohort, interferon-α is the most promising drug in contrasting visual acuity loss in cystoid macular edema. Visual prognosis remains severe in these patients.
authors.affiliation: Rheumatology and Clinical Immunology, Spedali Civili of Brescia, University of Brescia, Brescia, Italy.
authors.forename: Mara
authors.initials: M
authors.lastname: Taraborelli
authors.forename: Ilaria
authors.initials: I
authors.lastname: Cavazzana
authors.forename: Micaela
authors.initials: M
authors.lastname: Fredi
authors.forename: Paolo
authors.initials: P
authors.lastname: Airò
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Nascimbeni
authors.forename: Angela
authors.initials: A
authors.lastname: Tincani
authors.forename: Franco
authors.initials: F
authors.lastname: Franceschini
mesh_terms: D000328:Adult; D015331:Cohort Studies; D016572:Cyclosporine / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D059949:HLA-B51 Antigen / Q000737:chemistry; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D000069285:Infliximab / Q000627:therapeutic use; D016898:Interferon-alpha / Q000378:metabolism / Q000627:therapeutic use; D008269:Macular Edema / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D015995:Prevalence; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014605:Uveitis / Q000628:therapy; D014792:Visual Acuity
chemical_list: D059949:HLA-B51 Antigen; D007166:Immunosuppressive Agents; D016898:Interferon-alpha; D016572:Cyclosporine; D000069285:Infliximab; D009173:Mycophenolic Acid