Macular Edema in Uveitis

Abstract

In the present study we have made a review of the relevant literature on pathogenesis and modern diagnostic methods for macular edema (ME) in uveitis. Macular edema is a typical non-specifi c complication of uveitis, one of the common causes of visual impairment. ME can be found in all types of uveitis. In 85% of cases of intermediate uveitis, the visual impairment is due to the development of cystoid macular edema. The macula is more rarely affected in panuveitis (35%), anterior (20-26%) and posterior (20%) uveitis. The etiological agent is of great importance for the course and treatment of infl ammatory diseases. Among the imaging diagnostic methods that are capable of detecting macular edema with fl uid accumulation in the retina (either diffuse or distributed in cysts) are the fl uorescein angiography (FA) and the optical coherence tomography (ОСТ). OCT allows a quantitative assessment of retinal thickening and how it changes throughout therapy. FA can be used to determine very precisely the site of a vascular leakage and assess how badly the vascular wall has been affected by the infl ammatory process. CONCLUSION: Macular edema occurring during an infl ammatory process is one of the causes for visual acuity loss in uveitis. OCT and FA are useful complementary imaging methods for investigation of structural changes in retinal architecture in uveitis patients.

Risk of Ocular Complications in Patients with Noninfectious Intermediate Uveitis, Posterior Uveitis, or Panuveitis

“…5 In other studies, macular edema has been estimated to be present in 85% of cases of intermediate uveitis, 35% of cases of panuveitis, and 20% of cases of posterior uveitis, causing up to 30% of permanent uveitis-related vision loss. 7,23,24 Cataract is another significant cause of vision loss in patients with uveitis, present in 18% to 35% of patients. 7,15 Long-term corticosteroid use (systemic or local) for the treatment of uveitis can lead to glaucoma and cataract, to which significant ocular morbidity can be attributed.…”

Optical coherence tomography angiography in intermediate uveitis-related cystoid macular edema

“…The frequency of cystoid macular edema (CME) varies in different uveitis entities, ranging from 66% in patients with panuveitis to 11% in those with anterior uveitis. It is a leading cause of permanent visual impairment in approximately 40-50% of patients with uveitis [1] and the most frequent cause of visual impairment in patients with intermediate uveitis (IU) [2][3][4]. Patients with IU and associated systemic diseases are less likely to exhibit macular edema [5].…”

OCT-Angiographic Findings in Intermediate Uveitis-related Refractory Macular Edema

“…Cystoid macular edema (CME) is the main cause of permanent visual impairment in almost 40 to 50% of patients with uveitis [1] , and up to 80% in patients with intermediate uveitis. [2][3][4] Strong associations have been shown between the occurrence of CME and various speci c uveitis entities. Panuveitis showed the strongest association, with 66% of patients having CME, followed by intermediate uveitis at 60%, posterior uveitis at 34%, scleritis at 13%, and anterior uveitis at 11%.…”