Treatment of uveitic macular edema: a review

To review the treatment modalities commonly available or under investigation for uveitic macular edema.

Corticosteroids are a mainstay of treatment and can be administered topically, periocularly, intravitreally, suprachoroidally, and systemically. Advances in drug development aim to target delivery of corticosteroids to the posterior segment while sparing anterior segment structures to avoid intraocular pressure elevation and cataract formation. Nonsteroidal alternatives including intravitreal anti-VEGF, intravitreal methotrexate, intravitreal anti-IL6, systemic acetazolamide, systemic antimetabolites, systemic biologics, and interferons have all been studied as alternatives that would allow for potential reduction or discontinuation of corticosteroid use. Pars plana vitrectomy remains a controversial option for patients with uveitic macular edema refractory to other medical therapies.

Uveitic macular edema is a common complication of uveitis that can cause significant vision loss and persist even after the resolution of other signs of intraocular inflammation. Treatment modalities aim to reduce macular edema while limiting adverse effects.