Medical Therapy of Uveitic Macular Edema: Biologic Agents

ABSTRACT

Introduction: Uveitic macular edema (UME) is a significant cause of visual impairment in all uveitis types.

Methods: Reports that were cited in the MEDLINE database, that analyzed the effectiveness of biologics for UME in at least five patients, with a minimum follow-up of 3 months, published prior to April 1, 2019 were included. Reports that did not compare UME findings before and after the therapy, using either OCT or fluorescein angiography, were excluded.

Results: Case series that analyzed the efficacy of intravitreal anti-VEGF agents showed modest, short-term benefit. Studies that investigated systemic anti-TNF agents in patients with noninfectious uveitis reported a therapeutic effect on UME. Anti-IL-6 antibodies have shown promising results for most severe cases of noninfectious UME. Interferon represents an option for patients with persistent UME in infectious and noninfectious uveitis.

Conclusion: Multicenter, randomized controlled trials are needed to assess the effectiveness of each group of biologic agents in sufficient number of patients.

KEYWORDS:

• Uveitis
• macular edema
• medical therapy
• biologic agents
• vascular endothelial growth factor
• tumor necrosis factor inhibitors
• interleukin 6 inhibitor
• interferon

Declaration of interest

The authors report no conflicts of interest.