Table S1.
Studies found for interventions of uveitic macular edema
| Study | Type | Intervention | Control | Size (eyes) | Result | Complications | Follow-up (months) |
|---|---|---|---|---|---|---|---|
| Leder et al63 | RS | Periocular injection | Nil | 126 | ME resolution 57%, 23 eyes failed repeated injections | IOP increase 43%, 4 required glaucoma filtration surgery, cataracts 17%, scleral perforation with subsequent subretinal corticosteroid deposition and retinal detachment was noted in 1 of 155 | 12 |
| Venkatesh et al14 | RCT | Periocular injection, 3 types | Types | 30 | Group 1 improvement, P = 0.00 | IOP increase in 3 groups | 3 |
| Jea et al17 | RS (S) | Periocular injection | Nil | 85 | Outcome IOP | IOP increased significantly, P = 0.001 | 3 |
| Yoshikawa et al64 | RS | Periocular injection | Nil | 39 | VA improvement, two lines 56.4%; VA improvement at 6 months 68% | Cataract 15.3%, glaucoma in 2.5%, blepharoptosis 2.5% | 6 |
| Bae et al68 | RS | IVTA/IVB/PSTA | Tx | 31 | IVT better than IVB and PSTA nonsignificant | IOP 45% IVT, 10% IVB, 40% PSTA | 5.6 |
| Soheilian et al57 | RCT | IVTA/IVB | Tx | 31 | VA improved in both groups, no significant difference between groups | Posterior subcapsular cataract increase was significant in IVT group | 9 |
| Soheilian et al57 | CCS | IV diclofenac | Nil | 10 | Improved VA 50%, P = 0.07; nil change in CMT | Nil | 2 |
| Roesel104 | RS | IVT/OFTA | Tx | 97 | VA improvement 18% (IVTA) and 20% (OFTA) after 12 months | IOP 22% in IVTA group, cataract progression 68% in IVTA group, and 27% in OFTA | 12 |
| Maca et al75 | RS | IVTA | Nil | 24 | VA 37.5%, resolution ME 29.3% | IOP increase > 25 mmHg, 25% cataract progression 26.6% | 11 ± 8 |
| Lasave et al67 | RS | IVTA/IVB | Nil | 36 | VA improvement – IVT P = 0.01, IVB P = 0.03 CMT improvement in IVT group, P = 0.0004 |
Increase in IOP in IVT group, no CVA, TIA, or MI | 6 |
| Dong et al74 | RS | IVTA | Nil | 8 | Improvement in VA, P = 0.13; 75% ME, P = 0.04 | IOP increase in 25% | 9 |
| Sallam et al72 | RCS | IVTA | Nil | 41 | VA improvement, P < 0.01 | 46% IOP increase, cataract | 7 |
| Hogewind105 | RCS | IVTA | Nil | 33 | VA improved in 48% of intermediate uveitis group and 32% of the posterior uveitis group | 12 eyes had an increase in IOP > 21 mmHg, 36% cataract surgery | 10.6 |
| Morrison et al77 | CCS | IVT in px with AIDS | Observed patients | 8 | Improvement in VA 35% compared to 13% in observed group; P = 0.04 | IOP increase in 11% treated group, 2% in observed group | 9 |
| Choudhry and Ghosh8 | CCS | IVTA/PSTA | Tx | 20 | VA improved 88.9% vs 77.8%, P = 0.53; ME resolution, no difference, 6 months, P = 0.53 | IOP recorded was greater in the eyes that received IVTA than those that received PSTA (P < 0.001) | 6 |
| Atmaca et al71 | CT | IVTA | Nil | 10 | Improvement: 70% VA, 80% ME | IOP increase in 60% | 15.6 |
| Das-Bhaumik and Jones70 | RCS | IVTA | Nil | 33 | 24/33 improvement (80%) | IOP increase in 22% | 13.5 |
| Kok et al69 | RS | IVTA | Nil | 65 | Mean improvement 0.26 | IOP increase in 43.1% | 8 |
| Angunawela et al6 | RS | IVTA | Nil | 12 | Improvement: 58% VA, 100% ME | IOP increase in 41.6% | 40.5 |
| Androudi et al76 | RS | IVTA | Nil | 20 | Improvement: VA 55%, ME 50% complete | IOP controlled, cataract progression in 3 out of 15 | 8 |
| Smithen106 | S (RCS) | IVTA | Nil | 89 | 36 patients (40.4%) experienced a pressure elevation to 24 mmHg or higher at a mean of 100.6 days (SD 83.1 day) after treatment; glaucomatous patient 50% IOP rise |
10 | |
| Karacorlu et al73 | CT | IVTA | Nil | 10 | Improvement: 80% VA, 36.4% ME | IOP increase 30%; no cataract progression or injection-related complications were encountered | 7.2 |
| Young et al66 | CT | IVTA | Nil | 6 | Resolution of ME | IOP increase (30 mmHg) in 5 patients | 6 |
| Antcliff et al7 | CT | IVTA | Nil | 6 | ME resolution 83% | IOP increased, 1 patient required trabeculectomy | 3–12 |
| Lowder et al18 (posterior uveitis) | RCT | Dexamethasone IV implant | 0.7 mg, 0.35 mg, and sham | 229 | Vitreous haze improved. CMT was recorded but no data on patients with specific macular edema. VA improved in interventions, P < 0.01 | IOP increased, requiring medication in 23% 0.7 mg group; cataracts 15% and 12%; conjunctival heme and ocular irritation; single case of possible culture-negative endophthalmitis or uveitis flare (0.7 mg DEX implant group); 4 retinal detachments (2 in the 0.7 mg DEX implant group and 2 in the sham group) | 6.2 |
| Kempen et al25 (posterior and panuveitis) | RCT | Fluocinolone acetonide implant (implant therapy) (255 eyes) | Systemic corticosteroids plus immunosuppression | 734 | P = 0.16, 95% confidence interval on difference in improvement between groups, −1.2 to 6.7 letters). An improvement in vision-related quality of life of 11.4 and 6.8 units (P = 0.043), a change in EuroQol-EQ5D health utility of 0.02 and –0.02 (P = 0.060) | Over the 24-month period, implant-assigned eyes had a higher risk of cataract surgery (80%, hazard ratio [HR] = 3.3, P = 0.0001), treatment for elevated intraocular pressure (61%, HR = 4.2, P = 0.0001), and glaucoma (17%, HR = 4.2, P = 0.0008) | 24 |
| Pavesio et al21 | RCT | IV fluocinolone acetonide implant | Standard care (SOC) | 140 | Delayed and lower rate of recurrence P = 0.01 | IOP requiring surgery 21.2% Cataracts, 87.8% of phakic eyes |
36 |
| Jaffe24 (chronic uveitis) | CT | Fluocinolone acetonide sustained drug-delivery implant in patients with recurrence | Nil | 17 | The mean Snellen VA 12 months after the second implant insertion was 20/78, compared with 20/400 at the time of the original fluocinolone implant placement (P = 0.04) | 1/17 had a tractional retinal detachment, 1/17 had endophthalmitis | 12 |
| Callanan et al20 | RCT | IV fluocinolone acetonide implant, 0.59 mg and 2.1 mg | Nonimplanted eye | 278 | Reduction in ME in 86% and 73% of the implanted eyes compared to 28% and 28% of the fellow nonimplanted eye for the 0.59 mg FA dose, reduction of 70% and 45% of implanted eyes compared to 27% and 22% of the fellow non implanted eye for the 2.1 mg FA dose; P = 0.01 CMO decreased significantly: P = <0.01 |
Glaucoma surgery was required in 40%, cataracts were extracted in 93% of phakic implanted eyes, lysis of the anchoring suture 1/278, endophthalmitis 1/278, spontaneous dissociation of the cup and strut 1/278 | 36 |
| Kuppermann et al59 | RCT | IV dexamethasone (DDS) | Observed patients | 27 | 10-letter improvement in 54% of DDS patients compared to 14% observed patients | Eye pain and irritations; vitreous heme, vitreous disorders, increased IOP and conjunctival heme was significantly more in the intervention group compared to the observed group | 3.21 |
| Goldstein107 | S | FA implants | Nil | 584 | 71.0% of implanted eyes had an IOP increase of 10 mmHg or more than baseline and 55.1%, 24.7%, and 6.2% of eyes reached an IOP of 30 mmHg or more, 40 mmHg or more, and 50 mmHg or more, respectively; was controlled by surgery and medication | 36 | |
| Jaffe et al22 (posterior uveitis) | RCT | IV FA implant | Dose 0.59 mg or 2.1 mg | 278 | VA improved in 87%. 0.53 logMAR (20/68); this improved significantly to 0.45 logMAR (20/55) by 34 weeks (P < 0.001) | 51% required ocular antihypertensives, 5.8% glaucoma filtration surgery, 9.9% cataract surgery | 8.5 |
| Jaffe et al23 (posterior uveitis) | RCT | IV FA implant | Dose 0.59 mg or 2.1 mg | 36 | VA improved 0.81 logMAR units (20/125) at 30 months (P = 0.05) | IOP rise 56.1%, 19.4% patients had glaucoma filtration surgery, 50% cataracts | 22.45 |
| Missotten28 | RCS | Octreotide | Nil | 20 | ME resolution 36.4% after 1 year | Elevated liver enzymes, unstable glycemic control | 12 |
| Kafkala et al27 | CCS | Octreotide | Nil | 9 | ME resolution 78%, VA improved in 78% | Nil | 12.4 |
| Papadaki et al110 | RS | Octreotide | Nil | 2 | Partial resolution of ME | Gastrointestinal upset, transient pain at the injection site | 6 |
| Schilling et al111 | RCS | Acetazolamide | Nil | 45 | VA improved: P = 0.012, P = 0.025 | Nil | 37.2 |
| Lashay et al62 | RCT | Acetazolamide (Behçet’s) | Placebo crossover | 67 | FFA improved: P = 0.99, VA P = 0.53 | Mild nausea and pins and needles in a few patients; all continued treatment | 3 |
| Cox108 | CCS | Acetazolamide | Nil | 41 | 16 patients responded with improvement with VA | Paresthesia, nausea, altered taste, and mild depression | 30 |
| Whitcup et al60 | RCT | Acetazolamide | Placebo | 40 | Reduced ME (P = 0.01) no difference in VA | 92% adverse drug reactions | 4 |
| Farber et al61 | RCT | Acetazolamide | Placebo | 30 | Statistically significant improvement in VA was seen at 14 and 28 days in the treated patients | Paresthesia, nausea, drowsiness, weight loss, chronic fatigue, cutaneous allergic reaction | 1 |
| Meyer et al34 | S | Anti-VEGF IV rhegmatogenous RD | 35,942 | N/A | Rhegmatogenous RD 0.013% incidence | 3 | |
| Mirshahi et al85 | CCS | IVB | Nil | 12 | VA improved 58%, P < 0.05; ME P = 0.64 | Nil | 4 |
| Lott et al88 | RCS | IVB | Nil | 34 | Nil significant change | Nil | 7 |
| Al-Dhibi89 | RCS | IVB | Nil | 1 child | VA improved, ME improved but recurred | Nil | 2 |
| Acharya et al82 | CCS | IVR | Nil | 7 | Improved ME, P = 0.03 | Nil | 6 |
| Mackensen et al81 | RS | IVB | Nil | 10 | Improved ME, P = 0.0082; VA nonsignificant | One patient’s preexisting cataract progressed after two injections | 1 |
| Fintak et al32 | S | IVB/IVR endophthalmitis | N/A | 12,585 of IBV 14320I of IVR | N/A | Endophthalmitis 0.02% incidence | 1 |
| Ziemssen et al83 | RS | IVB | Nil | 6 | Nil change in ME or VA | Rupture retinal cyst | 12 |
| Cordero Coma et al84 | RS | IVB | Nil | 13 | ME 46.15%, P = 0.02; VA 38.4%, P = 0.05 | Nil | 3 |
| Cervantes-Castañeda et al87 | RCS | IVB | Nil | 29 | VA improved, P = 0.0045; ME P = 0.0007 | Nil | 12 |
| Wang et al38 | RS | Efalizumab S/C | Nil | 1 | Resolved ME | Pain in the left hip joint, short-term-memory loss, inability to perform multitasking activities, twitching in the right arm | 6 |
| Parie et al112 | RCS | Interferon-α | Nil | 6 | Improved VA and ME | Not known | |
| Androudi et al35 | CCS | IV adalimumab | Nil | 8 | No improvement in VA or ME | Nil | 6 |
| Taylor et al92 | CCS | Methotrexate | Nil | 15 | VA improved, 5 relapsed and improved with reinjection | 1 dense posterior capsular plaque that needed vitrectomy and surgical capsulotomy, 1 epitheliopathy | 6 |
| Neri109 | RCS | Mycophenolate | Nil | 19 | 96.9% had no ME on FFA and OCT, 3 recurrences | Tiredness 26.3%, headache 21%, dizziness 15.8%, anorexia 21%, dyspepsia 31.6%, raised cholesterol 5.3% | 12 |
| Deuter et al40 | RS | Interferon-α-2A | 24 | ME resolution 62.5% in 3 months | Flu-like symptoms, fatigue, or increased liver enzymes | 6 | |
| Fukuda et al91 | RS | Etanercept | Nil | 2 | Improved ME and VA | Not known | 4 |
| Bodaghi et al41 | RS | Interferon-α | Nil | 45 | Control in 59%–82.6%; oral prednisolone decreased significantly (P = 0.001), relapses in 5 cases | 2 (5.13%) had major side effects – severe depression and major neutropenia; minor side effects were flu-like symptoms, coughing, arthralgias, thyroiditis and Raynaud’s phenomenon | 24.2 |
| Hardwig et al51 | RCS | Methotrexate | Nil | 6 uveitis | 12/16 VA improvement, 4 lost acuity | PCNSL | 4.2 |
| Deuter et al40 | CT | Interferon-α-2A | Nil | 15 | Resolution of ME in 11, improved VA 13 | Flu-like symptoms, fatigue, hair loss, and increased liver enzymes in 3–7 patients | 0.5–1 |
| Markomichelakis et al37 | CSS | Infliximab | Nil | 14 | VA improved, P = 0.00001; ME P = 0001 | Nil | 6 |
| Gutfleisch et al55 | RS | PPV and IVT | Nil | 19 | Improved VA in 44%, worse in 12% | Cataract progression, 85% of phakic eyes; increased IOP 27% at 6 weeks, 11% at 12 months | 12 |
| Tranos et al58 | RCT | PPV | Standard care | 23 | Improved VA significantly, P = 0.011 | 1 peripheral retinal break was treated with laser; 2 eyes with ocular hypertension treated with drops | 6 |
| Sonoda et al93 | RCS | PPV and IVT | Nil | 6 | Improved VA, 83% | Increased IOP 17% | 7 |
| Wiechens et al94 | RCS | PPV | Nil | 42 | ME resolution 42.8%, VA 50.0% | ERM 2.3%, glaucoma 4.6%, RD 7.12% | 20.2 |
| Kiryu et al95 | RCS | PPV | Nil | 18 | VA improved 56%, ME 78% (slit lamp, not OCT) | Cataract, glaucoma, optic nerve atrophy, ERM, and TRD | |
| Dugel56 | RCS | PPV | Nil | 11 | VA improved 64%, ME 82% | Cataract formation 9%, glaucoma 18%, ERM 9% | 21 |
| Nussenblatt et al96 | RCT | Vitamin E | Placebo | 17 | No effect | Not documented | 4 |
| Suttorp-Schulten et al97 | CCS | Macular grid laser | Nil | 6 | ME reduced, 1 patient significant improvement in VA, 3 eyes were stable, and 2 eyes deteriorated | Nil | 18 |
Abbreviations: CCS, clinical case series; CMO, cystoid macular edema; CMT, central macular thickness; CT, clinical trial; CVA, cerebrovascular accident; DDS, drug delivery system; DEX, dexamethasone; ERM, epiretinal membrane; EuroQol Eq5D, health score; FA, fluocinolone acetonide; FFA, fundus fluorescein angiography; IOP, intraocular pressure; IV, intravitreal; IVB, intravitreal bevacizumab; IVR, intravitreal ranibizumab; IVT, intravitreal triamcinolone; IVTA, intravitreal triamcinolone acetonide; logMAR, logarithm of minimum angle of resolution; ME, macular edema; MI, myocardial infarct; OCT, optical coherence tomography; OFTA, orbital floor triamcinolone acetonide; PCNSL, primary central nervous system lymphoma; PPV, pars plana vitrectomy; PSTA, posterior subtenon triamcinolone acetonide; px, patient; RCS, retrospective clinical case series; RCT, randomized controlled trial; RD, retinal detachment; RS, retrospective review; S, safety study; S/C, subcutaneous; SD, standard deviation; SOC, standard of care; TIA, transient ischemic attack; TRD, tractional retinal detachment; Tx, treatment; VA, visual acuity; VEGF, vascular endothelial growth factor.