Department of Ophthalmology, Faculty of Medicine, University of Belgrade , Belgrade, Serbia.
Uveitis & Cornea Services, Sankara Nethralaya , Chennai, India.
Ocul Immunol Inflamm. 2020 Nov 16;28(8):1239-1250. doi: 10.1080/09273948.2019.1709648. Epub 2020 Feb 14.
: Uveitic macular edema (UME) is a significant cause of visual impairment in all uveitis types. : 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. : 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. : Multicenter, randomized controlled trials are needed to assess the effectiveness of each group of biologic agents in sufficient number of patients.
葡萄膜炎相关性黄斑水肿(UME)是所有类型葡萄膜炎导致视力损害的重要原因。检索 MEDLINE 数据库中截至 2019 年 4 月 1 日的文献,纳入至少 5 例患者、随访时间至少 3 个月、分析生物制剂治疗 UME 有效性的研究。排除未采用 OCT 或荧光素血管造影术比较治疗前后 UME 结果的病例系列研究。分析玻璃体内抗血管内皮生长因子(anti-VEGF)药物疗效的研究显示短期疗效尚可。研究显示,对于非感染性葡萄膜炎患者,全身应用 TNF-α 拮抗剂有治疗 UME 的作用。抗 IL-6 抗体对大多数严重的非感染性 UME 病例显示出良好的效果。对于感染性和非感染性葡萄膜炎中持续性 UME 的患者,干扰素也是一种选择。需要多中心、随机对照试验来评估每组生物制剂在足够数量患者中的有效性。