Given sufficient time and treatment, nearly all uveitic macular edema cases appear to resolve, but episodes of relapse may be common, a new study published online in Ophthalmology reports. The research team also found visual acuity was better in eyes with resolved macular edema, suggesting that control of inflammation and resolution of the condition might be visually-relevant treatment targets.
The study included 248 eyes of 177 participants with uveitic macular edema who were enrolled in the Multicenter Uveitis Steroid Treatment (MUST) Trial and follow-up study. Reading center graders masked to the clinical data graded OCT measurements taken at baseline and again annually. The study defined macular edema as a center point macular thickness of 240μm or greater as seen on time-domain OCT or an equivalent. Resolution of macular edema was defined as normalization of macular thickness on OCT, and relapse was considered an increase in macular thickness to 240μm or greater in an eye that previously had resolution. Visual acuity was measured at each visit with logarithmic visual acuity charts.
Among 227 eyes with macular edema, the researchers found the cumulative percent that resolved at any point during seven years of follow up was 94%. Additionally, the researchers observed an association between epiretinal membranes on OCT with a lower likelihood of resolution.
In the 177 eyes that achieved resolution, the cumulative percent with relapse within seven years was 43%. Eyes in which macular edema resolved gained a mean of 6.24 letters compared with eyes that remained free from macular edema during the one-year follow-up interval. However, eyes that did not achieve resolution experienced no visual gains, and those that developed macular edema during the first year of follow up lost a mean of -8.65 letters.
Tomkins-Netzer O, Lightman SL, Burke AE, et al. Seven-year outcomes of uveitic macular edema: the Multicenter Uveitis Steroid Treatment (MUST) Trial and Follow-up Study results. Ophthalmology. September 9, 2020. [Epub ahead of print].