Understanding uveitic macular edema

Inflammation inside the eye is called uveitis.13 Around one third  of people who have uveitis will also experience a common complication called UME, where fluid builds up in the macula (the central part of the retina). This fluid buildup is driven by inflammatory proteins, such as Interleukin-6 (IL-6), which cause the blood vessels in the retina to leak. UME is the leading cause of vision loss in people with uveitis.7-10, 14-17,18

UME can be chronic or fluctuate between periods of disease activity or inactivity (recurrent).16

UME can have a significant negative impact on people’s lives, affecting their physical and mental health, as well as social functioning and the vision needed for day-to-day activities such as driving and reading.15,19

How is UME diagnosed

The gold standard for diagnosing UME is a retinal image scan, called Spectral Domain Optical Coherence Tomography (SD-OCT), which takes cross-section photos of the retina. This can sometimes be supplemented by fluorescein angiography, where people are injected with a dye and then a special camera is used to photograph the retina.20

What are the signs and symptoms of UME?

The signs and symptoms of UME include:10, 15, 21-24

• Impaired central vision

• Blind spots in the central line of vision

• Edges and straight lines appearing wavy

• Difficulty seeing at distance or doing detailed work

• Impaired depth perception

• Difficulty distinguishing between colours 

Are there risk factors for developing UME?

Some people are more likely to develop UME than others. Factors that make UME more likely include:21, 25, 26

• Uncontrolled inflammation in the eye

• Smoking

• Gender – uveitis is slightly more prevalent in females

Current treatment options

The main treatment option for UME is steroids, a type of drug that helps to reduce inflammation. But these are associated with significant serious side effects, such as increased pressure in the eye, glaucoma and cataracts, and the effectiveness of this treatment option is limited.27-32 

Despite control of inflammation with current therapies for uveitis, UME may persist in approximately 40% of cases.33

Currently, there is only one therapy approved for UME in the US and no approved therapies outside of the US.34 There is currently no approved non-steroid, intravitreal (eye injection), targeted treatments that address the underlying causes of disease in UME.34