Long-term control of cystoid macular oedema in noninfectious uveitis with Mycophenolate Mofetil

Abstract

MMF was safe and effective in controlling CMO and in reducing the uveitis relapse rate in patients not responding to traditional immunosuppressants. Further case-controlled studies are mandatory to validate those preliminary results.

Mycophenolate Mofetil in the Therapy of Uveitic Macular Edema—Long-term Results

“…22 Resolution of macular edema was found in 95% of the patients after 1 year of follow-up. Our results are less favorable than the results reported in this study because of the different follow-up time and the more strength criteria for treatment efficacy that we used to exclude the effect of additional corticosteroid and acetazolamide therapy on the treatment outcome.…”

“…Only a few previous publications have addressed the use of immunosuppressive drugs for CMO in particular, and the data were restricted to a limited period of 1 year. 7,22 In all patients of group A, CMO had been ineffectively pretreated with a combination therapy of systemic Complete resolution of CMO 6 (60%) 2 (67%) Incomplete resolution of CMO 4 (40%) 1 (33%) Note. Group A: uveitis patients in whom CMO had occurred before initiation of MMF treatment; group B: uveitis patients in whom CMO developed for the first time during MMF therapy.…”

“…[15][16][17][18][19][20][21] Recently, Neri et al have reported favorable results with MMF in the therapy of 19 patients with uveitic macular edema after 1 year of treatment. 22 However, no data are available beyond 1 year regarding the use of MMF in macular edema. The aim of 204 D. Doycheva et al Ocular Immunology & Inflammation this retrospective study was to analyze the long-term efficacy of mycophenolate mofetil in the treatment of cystoid macular edema in noninfectious uveitis.…”

Clinical Review: Update on Treatment of Inflammatory Macular Edema

“…68,69 Although the bevacizumab molecule (being a full-length antibody) is theoretically more immunogenic than the ranibizumab molecule (being only an antibody fragment), no difference was found in the risk of uveitis after bevacizumab injections vs. ranibizumab injections. 71 The pathogenesis of this type of uveitis is not understood, but possible explanations include contamination of the medications with bacterial endotoxin, formation of antibodies against the immunogenic anti-VEGF molecules, and leaching of contaminants of disposable syringes into its contents. None of the studies on the use of anti-VEGF injections in uveitic patients reported a recurrence or an exacerbation of inflammation.…”

“…One study focused on ME in 19 uveitic patients who were unresponsive to traditional immunosuppressants and who were treated with mycophenolate mofetil. 71 Mycophenolate mofetil proved to be safe and very effective in controlling ME and in reducing the uveitis relapse rate. Intravitreal methotrexate was given in 15 eyes to treat ME with a promising effect.…”