Teper Slawomir Jan
Clinical Department of Ophthalmology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-760 Katowice, Poland.
J Clin Med. 2021 Sep 14;10(18):4133. doi: 10.3390/jcm10184133.
Uveitic macular edema (ME) is a frequent complication in 8.3% of uveitis patients and is a leading cause of serious visual impairment in about 40% of cases. Despite the numerous available drugs for its treatment, at least a third of patients fail to achieve satisfactory improvement in visual acuity. First-line drugs are steroids administered by various routes, but drug intolerance or ineffectiveness occur frequently, requiring the addition of other groups of therapeutic drugs. Immunomodulatory and biological drugs can have positive effects on inflammation and often on the accompanying ME, but most uveitic randomized clinical trials to date have not aimed to reduce ME; hence, there is no clear scientific evidence of their effectiveness in this regard. Before starting therapy to reduce general or local immunity, infectious causes of inflammation should be ruled out. This paper discusses local and systemic drugs, including steroids, biological drugs, immunomodulators, VEGF inhibitors, and anti-infection medication.
葡萄膜炎性黄斑水肿（ME）是8.3%的葡萄膜炎患者常见的并发症，约40%的病例中是严重视力损害的主要原因。尽管有众多药物可用于治疗，但至少三分之一的患者视力未能得到满意改善。一线药物是通过各种途径给药的类固醇，但药物不耐受或无效情况频繁发生，需要加用其他治疗药物组。免疫调节和生物药物可对炎症产生积极作用，通常对伴随的ME也有作用，但迄今为止大多数葡萄膜炎随机临床试验并非旨在减少ME；因此，在这方面尚无明确的科学证据证明其有效性。在开始降低全身或局部免疫的治疗之前，应排除炎症的感染性病因。本文讨论了局部和全身药物，包括类固醇、生物药物、免疫调节剂、血管内皮生长因子（VEGF）抑制剂和抗感染药物。
