Uveitic macular edema

Area of Science:

• Ophthalmology
• Immunology

Background:

• Macular edema (ME) is a potential complication of anterior, intermediate, and posterior uveitis.
• The pathogenesis of Uveitic ME (UME) involves blood-retinal barrier (BRB) breakdown.
• Causes of uveitis include infectious, neoplastic, or autoimmune etiologies.

Purpose of the Study:

• To review the diagnostic tools and therapeutic strategies for uveitic macular edema.
• To highlight the role of imaging and treatment modalities in managing UME.

Main Methods:

• Optical coherence tomography (OCT) is a standard non-invasive diagnostic tool for macular thickening.
• Retinal fluorescein and indocyanine green angiography aid in evaluating the macula, vasculitis, ischemia, and neovascularization.
• Review of current and emerging therapeutic approaches, including corticosteroids, immunomodulators, and biotherapies.

Main Results:

• OCT provides sensitive and reproducible confirmation of macular thickening.
• Angiography offers insights into etiology, complications, and therapeutic response.
• Corticosteroids (intravitreal, subconjunctival, subtenon) are common but have limitations.
• Systemic treatments and immunomodulatory agents are used for persistent or bilateral cases.

Conclusions:

• UME diagnosis relies on OCT and angiography.
• Treatment strategies vary based on etiology and persistence, ranging from corticosteroids to systemic immunomodulators.
• Emerging biotherapies and immunomodulators are under investigation for safety and efficacy in UME management.