uveitic macular edema nihal elshakankiry, md, phd professor of ophthalmology rowayda m. amin, msc...

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.