RESOLUTION OF NONINFECTIOUS UVEITIC CYSTOID MACULAR EDEMA WITH TOPICAL DIFLUPREDNATE. Issue 5 (May 2017)

• Record Type: Journal Article
• Authors: Feiler, Daniel L.; Srivastava, Sunil K.; Pichi, Francesco; Bena, James; Lowder, Careen Y.
• Is Part Of: Retina. Volume 37:Issue 5(2017:May)
• Publication Date: 2017-05
• Subjects: corticosteroids -- cystoid macular edema -- difluprednate -- uveitic cystoid macular edema -- uveitic macular edema -- uveitis; Retina -- Diseases -- Periodicals; Retinal Diseases; Vitreous Body; 617.735
• DOI: 10.1097/IAE.0000000000001243
• Languages: English
• ISSNs: 0275-004X

Abstract

Abstract : Purpose: To evaluate the short-term safety and efficacy of topical difluprednate (0.05%) for the treatment of noninfectious uveitic cystoid macular edema. Methods: Twenty-seven patients (35 eyes) undergoing treatment with difluprednate 4 times daily for 3 weeks for noninfectious uveitic cystoid macular edema were reviewed for visual acuity, intraocular pressure, optical coherence tomography, and fluorescein angiography results. A mixed model analysis was fit with each measure as the outcome, visit as the primary predictor, and patient and eye as random effects. Results: Mean central foveal thickness decreased by 117 μ m ( P < 0.001) at 30 ± 15 days, 124 μ m ( P < 0.001) at 60 ± 15 days, and 152 μ m ( P < 0.001) at 180 ± 30 days. Complete resolution of intraretinal fluid was observed in 15 of 34 (44%) eyes at 30 ± 15 days, 11 of 21 (52%) eyes at 60 ± 15 days, and 9 of 12 (75%) eyes at 180 ± 30 days. Improvement in fluorescein leakage was noted in 7 of 8 eyes (88%). Visual acuity improved by a mean of 5 letters ( P = 0.001) at 30 ± 15 days, 5.5 letters ( P = 0.007) at 60 ± 15 days, and 7 letters ( P = 0.032) at 180 ± 30 days. Mean increase in intraocular pressure was 1.48 mmHg at 30 ± 15 days ( P = 0.080), 1.92 mmHg at 60 ± 15 days ( P = 0.110), and 6.18 mmHg ( P = 0.001) at 180 ± 30 days. Conclusion: Topical difluprednate is a well-tolerated and effective treatment for noninfectious uveitic cystoid macular edema with decreased central foveal thickness, mild improvement in visual acuity, and elevation of intraocular pressure observed in a few patients. Abstract : This retrospective study demonstrates that difluprednate ophthalmic emulsion (0.05%) given four times daily for 3 weeks reduces central foveal thickness on optical coherence tomography in noninfectious uveitic cystoid macular edema with a mild increase in intraocular pressure.