Abstract
The aim of this study was to describe a single-center experience in the treatment and follow-up of cystoid macular edema patients. Clinical records of all patients with cystoid macular edema followed up in the Rheumatologic and Ophthalmological Unit of our center between 1993 and 2013 were retrospectively evaluated. The outcome was assessed by visual acuity and optical coherence tomography status during follow-up. Comparisons were made by Fisher’s exact test (p < 0.05 significant). In this study 16 eyes in 9 patients were analyzed. Our study includes mainly post-uveitic (78 %) cases with a high prevalence of human leukocyte antigen B51 (67 %). Systemic immunosuppressive therapy was prescribed in 87 % of cases. The most frequently used drugs were cyclosporine, interferon-α, and infliximab. The first two molecules appeared respectively the most used as the first option and the one with the longest survival on treatment. Interferon-α was the most effective drug in contrasting visual acuity loss compared to the majority of drugs, but significantly more effective than mycophenolate (p = 0.01) in reducing macular edema. At the end of follow-up, 50 % of patients showed a significant visual loss, while 88 % did not present macular edema. In our small cohort, interferon-α is the most promising drug in contrasting visual acuity loss in cystoid macular edema. Visual prognosis remains severe in these patients.
Similar content being viewed by others
References
Bringmann A, Reichenbach A, Wiedemann P (2004) Pathomechanisms of cystoids macular edema. Ophthalmic Res 36:241–249
Scholl S, Augustin A, Loewenstein A, Rizzo S, Kuppermann BD (2011) General pathophysiology of macular edema. Eur J Ophthalmol 21(Suppl 6):S10–S19
Rothova A (2007) Inflammatory cystoid macular edema. Curr Opin Ophthalmol 18:487–492
Ossewaarde-van Norel A, Rothova A (2011) Clinical review: update on treatment of inflammatory macular edema. Ocul Immunol Inflamm 19:75–83
Deuter CME, Koetter I, Guenaydin I, Stuebiger N, Zierhut M (2006) Interferon alfa-2a: a new treatment option for long lasting refractory cystoid macular edema in uveitis? A pilot study. Retina 26:786–791
Theossiadis PG, Markomichelakis NN, Sfikakis PP (2007) Tumor necrosis factor antagonists. Preliminary evidence for an emerging approach in the treatment of ocular inflammation. Retina 27:399–413
International Study Group for Behçet’s Disease (1990) Criteria for diagnosis of Behçet’s disease. Lancet 335:1078–1080
International Team for the Revision of the International Criteria for Behçet’s Disease (ITR-ICBD), Davatchi F, Assaad-Khalil S et al (2014) The International Criteria for Behçet’s Disease (ICBD): a collaborative study of 27 countries on the sensitivity and specificity of the new criteria. J Eur Acad Dermatol Venereol 28:338–347
Deuter CM, Koetter I, Guenaydin I, Stuebiger N, Zierhut M (2006) Interferon alfa-2A: a new treatment option for long lasting refracorty cystoid macular edema in uveitis? Retina J Retina And Vitreous Dis 7:787–791
Lardenoye CW, van Kooij B, Rothova A (2006) Impact of macular edema on visual acuity in uveitis. Ophthalmol 113:1446–1449
Deuter CM, Kötter I, Günaydin I et al (2009) Efficacy and tolerability of interferon alpha treatment in patients with chronic cystoids macular oedema due to non-infectious uveitis. Br J Ophthalmol 93:906–913
Paire V, Lebreton O, Weber M (2010) Effectiveness of interferon alpha in the treatment of uveitis macular edema refractory to corticosteroid and/or immunosuppressive treatment. J Fr Ophtalmol 33:152–162
Butler NJ, Suhler EB, Rosenbaum JT (2012) Interferon alpha 2b in the treatment of uveitic cystoids macular edema. Ocul Immunol Inflamm 20:86–90
Markomichelakis NN, Theodossiadis PG, Pantelia E et al (2004) Infliximab for chronic cystoid macular edema associated with uveitis. Am J Ophthalmol 138:648–650
Theodossiadis PG, Markomichelakis NN, Sfikakis PP (2007) Tumor necrosis factor antagonists: preliminary evidence for an emerging approach in the treatment of ocular inflammation. Retina 27:399–413
Schaap-Fogler M, Amer R, Friling R, Priel E, Kramer M (2014) Anti-TNF-α agents for refractory cystoid macular edema associated with noninfectious uveitis. Graefes Arch Clin Exp Ophthalmol 252:633–640
Conflict of interest
The authors declare no conflicts of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Taraborelli, M., Cavazzana, I., Fredi, M. et al. Treatment and functional outcome of patients with cystoid macular edema: a single-center experience. Clin Rheumatol 34, 791–794 (2015). https://doi.org/10.1007/s10067-014-2694-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10067-014-2694-z