Interferon as a novel agent for management of macular edema: Where do we stand?

Inflammatory macular edema (IME) is a vision-threatening manifestation of ocular inflammation that arises from diverse causes such as uveitis, postoperative inflammation, and drug-related reactions. Corticosteroids remain the cornerstone of management; however, their prolonged use poses significant limitations, creating a need for effective steroid-sparing alternatives. Interferons (IFNs) are long recognized for their immunomodulatory and anti-inflammatory effects and have recently gained attention as therapeutic options in the treatment of IME. This review consolidates current evidence of IFN therapy delivered through systemic, topical, and periocular routes in various etiologies of IME, including uveitic, pseudophakic, and postinfectious conditions. Analysis of 27 clinical studies demonstrates overall improvement in central macular thickness and visual outcomes with IFN therapy, along with a favorable safety profile. Newer administration routes, such as topical IFN drops, posterior subtenon's and subconjunctival injections, offer targeted therapy, avoiding systemic side effects, though frequent dosing may be required due to limited treatment durability. These emerging approaches expand the therapeutic landscape by providing novel nonsteroidal options for patients intolerant to or refractory to conventional therapy. Although most available studies are limited by small sample sizes and heterogeneity in protocols, the growing evidence supports IFN as a valuable adjunct or alternative in the management of IME. Further well-designed trials are warranted to establish standardized dosing, delivery protocols, and long-term safety profiles for these novel routes of administration of IFN.