Purpose: To determine the efficacy of medical treatment of cystoid macular
edema (CME) in patients with uveitis. Methods: Retrospective study of 40 pa
tients (57 eyes) with uveitis and CME. Inclusion criteria were presence of
CME with minimal and no macular pathology, or vascular disease which could
account for CME. Patients who had undergone intraocular surgery or had visu
al aucity (VA) of greater than or equal to 20/40 were excluded. The diagnos
is of CME was based on clinical and/or angiographic findings. Three treatme
nt groups were defined: (1) transseptal injection of steroids (n=13 eyes);
(2) systemic non steroidal anti-inflammatory drugs (NSAIDs) (n=11 eyes); bo
th 1 and 2 (n=33 eyes). Results: Overall, 79% of eyes improved 3 or more li
nes of Snellen VA after treatment: 51% improved 4 or more lines. The averag
e number of lines improved was 3.8 for eyes treated with transseptal inject
ions of steroids, 2.9 for eyes treated with NSAIDs, and 4 for eyes treated
with both. For all 3 treatment groups between 60-70% of eyes improving 2 or
more lines reached best VA only after a minimum of 6 months of follow up.
Conclusions: CME, a vision threatening complication of uveitis, respond fai
rly well to medical treatment; however, the best VA is achieved after sever
al months. The improvement in VA did not differ markedly among the three tr
eatment groups.