The status and advances of intravitreal injection in treatment of noninfectious uveitic macular edema_Chinese Journal of Ocular Fundus Diseases

Authors：

Song Jiayi , Chen Ting ,  Ai Ming

Eye Center, Renmin Hospital of Wuhan University, Wuhan 430060, China;

Corresponding author：

Ai Ming, Email: aiminghbwh@163.com

Keywords：

Uveitis; Macular edema; Intravitreal injections; Review

DOI：

10.3760/cma.j.cn511434-20210428-00214

Video：

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Abstract Full text Figures/Tables Video References Cited by

Noninfectious uveitic macular edema (NIU-ME) is a major cause of visual impairment in patients with uveitis. Intravitreal route can control inflammation rapidly, reduce macular edema, and improve vision with relatively lower doses of the drug. Currently, several intravitreal injection drugs have been used for the treatment of NIU-ME. Cataract and elevated intraocular pressure are the major complications. Due to its efficacy and safety, intravitreal drugs have gradually become an effective alternative to systemic treatment, especially in patients with unilateral disease. However, more studies are needed on drug selection, timing of injection and combination therapy in clinical practice. There are various treatments for NIU-ME, and the ultimate treatment should be individualized based on the severity of the disease, the risk/benefit ratio of each therapy, and the patient's tolerance.

Citation： Song Jiayi, Chen Ting, Ai Ming. The status and advances of intravitreal injection in treatment of noninfectious uveitic macular edema. Chinese Journal of Ocular Fundus Diseases, 2022, 38(5): 410-414. doi: 10.3760/cma.j.cn511434-20210428-00214 Copy

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6. Li YH, Hsu SL, Sheu SJ. A review of local therapy for the management of cystoid macular edema in uveitis[J]. Asia Pac J Ophthalmol (Phila), 2021, 10(1): 87-92. DOI: 10.1097/APO.0000000000000352.
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10. Maca SM, Abela-Formanek C, Kiss CG, et al. Intravitreal triamcinolone for persistent cystoid macular oedema in eyes with quiescent uveitis[J]. Clin Exp Ophthalmol, 2009, 37(4): 389-396. DOI: 10.1111/j.1442-9071.2009.02033.x.
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12. Fardeau C, Champion E, Massamba N, et al. Uveitic macular edema[J]. Eye (Lond), 2016, 30(10): 1277-1292. DOI: 10.1038/eye.2016.115.
13. Kok H, Lau C, Maycock N, et al. Outcome of intravitreal triamcinolone in uveitis[J/OL]. Ophthalmology, 2005, 112(11): 1916[2005-09-19]. https://pubmed.ncbi.nlm.nih.gov/16171868/. DOI: 10.1016/j.ophtha.2005.06.009.
14. Sallam A, Taylor SR, Habot-Wilner Z, et al. Repeat intravitreal triamcinolone acetonide injections in uveitic macular oedema[J/OL]. Acta Ophthalmol, 2012, 90(4): e323-325[2011-09-13]. https://pubmed.ncbi.nlm.nih.gov/21914149/. DOI: 10.1111/j.1755-3768.2011.02247.x.
15. Antcliff RJ, Spalton DJ, Stanford MR, et al. Intravitreal triamcinolone for uveitic cystoid macular edema: an optical coherence tomography study[J]. Ophthalmology, 2001, 108(4): 765-772. DOI: 10.1016/s0161-6420(00)00658-8.
16. Sallam A, Comer RM, Chang JH, et al. Short-term safety and efficacy of intravitreal triamcinolone acetonide for uveitic macular edema in children[J]. Arch Ophthalmol, 2008, 126(2): 200-205. DOI: 10.1001/archophthalmol.2007.59.
17. Yun S, Huang JJ. Routes for drug delivery: sustained-release devices[J]. Dev Ophthalmol, 2016, 55: 84-92. DOI: 10.1159/000434692.
18. Multicenter Uveitis Steroid Treatment (MUST) Trial Research Group, Kempen JH, Altaweel MM, et al. Randomized comparison of systemic anti-inflammatory therapy versus fluocinolone acetonide implant for intermediate, posterior, and panuveitis: the multicenter uveitis steroid treatment trial[J]. Ophthalmology, 2011, 118(10): 1916-1926. DOI: 10.1016/j.ophtha.2011.07.027.
19. Tomkins-Netzer O, Lightman S, Drye L, et al. Outcome of treatment of uveitic macular edema: the multicenter uveitis steroid treatment trial 2-year results[J]. Ophthalmology, 2015, 122(11): 2351-2359. DOI: 10.1016/j.ophtha.2015.07.036.
20. Sangwan VS, Pearson PA, Paul H, et al. Use of the fluocinolone acetonide intravitreal implant for the treatment of noninfectious posterior uveitis: 3-year results of a randomized clinical trial in a predominantly Asian population[J]. Ophthalmol Ther, 2015, 4(1): 1-19. DOI: 10.1007/s40123-014-0027-6.
21. Sen HN, Abreu FM, Louis TA, et al. Cataract surgery outcomes in uveitis: the multicenter uveitis steroid treatment trial[J]. Ophthalmology, 2016, 123(1): 183-190. DOI: 10.1016/j.ophtha.2015.09.022.
22. Itty S, Callanan D, Jones R, et al. Spontaneous dislocation of fluocinolone acetonide implant pellets from their suture struts[J]. Am J Ophthalmol, 2015, 159(5): 868-876. DOI: 10.1016/j.ajo.2015.01.031.
23. Jaffe GJ, Lin P, Keenan RT, et al. Injectable fluocinolone acetonide long-acting implant for noninfectious intermediate uveitis, posterior uveitis, and panuveitis: two-year results[J]. Ophthalmology, 2016, 123(9): 1940-1948. DOI: 10.1016/j.ophtha.2016.05.025.
24. Jaffe GJ, Foster CS, Pavesio CE, et al. Effect of an injectable fluocinolone acetonide insert on recurrence rates in chronic noninfectious uveitis affecting the posterior segment: twelve-month results[J]. Ophthalmology, 2019, 126(4): 601-610. DOI: 10.1016/j.ophtha.2018.10.033.
25. Weber LF, Marx S, Auffarth GU, et al. Injectable 0.19-mg fluocinolone acetonide intravitreal implant for the treatment of non-infectious uveitic macular edema[J]. J Ophthalmic Inflamm Infect, 2019, 9(1): 3. DOI: 10.1186/s12348-019-0168-9.
26. Pockar S, Leal I, Chhabra R, et al. Intravitreal fluocinolone 0.19 mg implant in the management of chronic non-infectious uveitis: 12-month outcomes from a single tertiary centre[J/OL]. Ocul Immunol Inflamm, 2021, 2021: 1-7[2021-06-14](2021-04-28). https://www.tandfonline.com/doi/abs/10.1080/09273948.2021.1922707?journalCode=ioii20. DOI:10.1080/09273948.2021.1922707. [published online ahead of print].
27. Mathis T, Cerquaglia A, Weber M, et al. Uveitis treated with dexamethasone implant[J]. Retina, 2021, 41(3): 620-629. DOI: 10.1097/IAE.0000000000002901.
28. Khurana RN, Porco TC. Efficacy and safety of dexamethasone intravitreal implant for persistent uveitic cystoid macular edema[J]. Retina, 2015, 35(8): 1640-1646. DOI: 10.1097/IAE.0000000000000515.
29. 叶娅, 宋艳萍. 地塞米松玻璃体腔植入剂治疗活动性非感染性葡萄膜炎黄斑水肿的疗效观察[J]. 中华眼底病杂志, 2020, 36(9): 691-696. DOI: 10.3760/cma.j.cn511434-20190903-00277.Ye Y, Song YP. Clinical efficacy of dexamethasone intravitreal Implant in the treatment of active non-infectious uveitis with macular edema[J]. Chin J Ocul Fundus Dis, 2020, 36(9): 691-696. DOI: 10.3760/cma.j.cn511434-20190903-00277.
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The status and advances of intravitreal injection in treatment of noninfectious uveitic macular edema

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