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.