Medical Therapy of Uveitic Macular Edema: Biologic Agents

Ocul Immunol Inflamm. 2020 Nov 16;28(8):1239-1250. doi: 10.1080/09273948.2019.1709648. Epub 2020 Feb 14.

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

Publication types

  • Review

MeSH terms

  • Biological Factors / therapeutic use*
  • Fluorescein Angiography
  • Humans
  • Macular Edema / diagnosis
  • Macular Edema / drug therapy*
  • Tomography, Optical Coherence
  • Uveitis / diagnosis
  • Uveitis / drug therapy*

Substances

  • Biological Factors