Abstract
Purpose:
To study the efficacy of bromfenac sodium solution in the treatment of macular edema secondary to non-infectious uveitis.
Methods:
The charts of 10 patients with macular edema due to non-infectious uveitis treated with bromfenac once daily for at least six months were reviewed. The data collected included information pertaining to patients' age, gender, diagnosis and location of uveitis, whether the inflammation is active and the visual acuity using the Snellen chart at each visit. The treatment modalities that were used were noted: oral, topical and intraocular steroids, immune-modulators, systemic or topical non steroidal anti-inflammatory drugs and the side effects of the latter. Optical Coherence Tomography provided the central and maximal macular thickness, presence of sub-retinal fluid and whether macular edema was cystic or diffuse.
Results:
13 eyes of 10 patients were included. 8 patients were females. 2 patients were diagnosed with sarcoid panuveitis, one patient had seronegative associated anterior uveitis and 8 patients were diagnosed with idiopathic uveitis (4 anterior and 3 panuveitis). All the patients were on topical corticosteroids and 8 were on systemic immune-modulators at the time of bromfenac initiation. There was a significant mean reduction in the maximum retinal thickness to 370, 350, and 339 μm (SD: 115, 58.8 and 58.3) at 4, 16 and 24 weeks respectively post treatment, compared with a baseline of 472 um (P=.013, .050 and .043, CI 95%). There was also a significant mean reduction in the central retinal thickness to 358, 292, and 258 μm (SD: 113.7, 101 and 13.4) at 4, 16 and 24 weeks respectively post treatment, compared with a baseline of 441 μm (P=.016, .025 and .043, CI 95%). 10 eyes had sub-retinal fluid collection at the time of bromfenac treatment initiation and it completely resolved in 9 eyes on last follow up. 10 eyes had cystoid macular edema prior to bromfenac, 7 of which resolved on last follow up. 5 out of 13 eyes improved by more than 2 lines on last follow up while vision remained stable in the rest of the eyes. Data on macular thickness and treatment instated up to 6 months prior to the start of bromfenac will be collected and compared to the data while on bromfenac treatment.
Conclusions:
Bromfenac may be an additional safe and effective modality of treatment in patients with uveitis induced macular edema.
Keywords: 746 uveitis-clinical/animal model •
585 macula/fovea •
505 edema