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Uveitic Macular EdemaNihal Elshakankiry, MD, PhD
Professor of OphthalmologyRowayda M. Amin, MSc
Assistant Lecturer of OphthalmologyAlexandria University
History 11 year old girl complaining of diminution of vision
in her OD 1 month prior to presentation diagnosed with JIA associated uveitis at the age of 5
years was on MTX 15mg/wk and topical steroids bid OU had cataract surgery OD at the age of 9 years
First presentation OD: BCVA: 6/36 AC +0.5 cell, minimal flare Pseudophakia Fundus:
Normal disc and vessels Thickened macula with blunted foveal reflex?
Uveitic macular edema?
First presentation
OS: BCVA: 6/9 Trace AC cell, mild flare Posterior synechae Normal fundus
OCT OD-First presentation
Cystoid macular edema 472 microns
Treatment
Bump up topical steroids to qid Posterior subtenon steroid injection OD
Posterior subtenon steroid injection
After One Month
OD: 463 microns BCVA 6/36
OS: 390 microns BCVA 6/18
After 3 Months
303 microns BCVA 6/9
After 5 Months
301 microns BCVA 6/9
Conclusion Uveitic macular edema is a vision compromising
complication that should be considered despite achieving remission with appropriate immunomodulatory treatment.
It is associated with certain uveitic entities including: JIA, BCR, Behcet’s disease. Adjunctive steroid therapy is often warranted for
treatment.