Macular edema associated with non-infectious uveitis: pathophysiology, etiology, prevalence, impact and management challenges

Macular edema associated with non-infectious uveitis: pathophysiology, etiology, prevalence, impact and management challenges

Macular edema (ME) is the most common sight-threatening complication in uveitis. The diagnostic and therapeutic management of the uveitic macular edema (UME) might be challenging due to the complex diagnostic workup and the difficulties physicians face to find the underlying cause, and due to its us...

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Bibliographic Details
Published in:Clinical ophthalmology (Auckland, N.Z.) Vol. 13; pp. 1761 - 1777
Main Authors: Massa, Horace, Pipis, Spyros Y, Adewoyin, Temilade, Vergados, Athanasios, Patra, Sudeshna, Panos, Georgios D
Format: Journal Article
Language:English
Published: Auckland Dove Medical Press Limited 01-09-2019
Taylor & Francis Ltd
Dove
Dove Medical Press
Subjects:
Adalimumab
Aflibercept
Angiotensin II
Anti-inflammatory agents
anti-TNF alpha
Antibodies
Azathioprine
Bevacizumab
Cidofovir
Corticosteroid drugs
corticosteroids
Cyclosporins
Development and progression
Edema
Etiology (Medicine)
Health aspects
immunomodulators
Inflammation
Infliximab
macular edema
Methotrexate
Monoclonal antibodies
Mycophenolate mofetil
Necrosis
non infectious uveitis
NSAIDs
Physicians
Ranibizumab
Review
Rifabutin
Tacrolimus
Topical drugs
Tumor necrosis factor
Tumor necrosis factor-TNF
Uveitis
United Kingdom
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Description
Summary:Macular edema (ME) is the most common sight-threatening complication in uveitis. The diagnostic and therapeutic management of the uveitic macular edema (UME) might be challenging due to the complex diagnostic workup and the difficulties physicians face to find the underlying cause, and due to its usually recurrent nature and the fact that it can be refractory to conventional treatment. Some of the mild cases can be treated with topical steroids, which can be combined with non-steroid anti-inflammatory drugs. However, immunomodulators such as methotrexate, tacrolimus, azathioprine, cyclosporine and mycophenolate mofetil together with anti-t[micro]mor necrosis factor-[alpha] (anti-TNF alpha) monoclonal antibodies such as adalimumab and infliximab, may be required to control the inflammation and the associated ME in refractory cases, or when an underlying disease is present. This review of the literature will focus mostly on the non-infectious UME. Keywords: non-infectious uveitis, macular edema, NSAIDs, anti-TNF alpha, corticosteroids, immunomodulators
Bibliography:ObjectType-Article-2
SourceType-Scholarly Journals-1
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These authors contributed equally to this work
ISSN:1177-5483
1177-5467
1177-5483
DOI:10.2147/OPTH.S180580