Intravitreal Adalimumab for Refractory Uveitis-Related Macular Edema

Objective: To evaluate the safety and efficacy of intravitreal adalimumab injections on refractory cystoid macular edema (CME) secondary to noninfectious uveitis. Design: Prospective, noncomparative, interventional case series. Participants: Eight consecutive patients with controlled uveitis and chronic, refractory CME who had failed steroid treatment. Intervention: Intravitreal adalimumab injections were given monthly for 3 months. Main Outcome Measures: Mean change in central retinal thickness (CRT) on optical coherence tomography (OCT); secondary objective was the mean change in best-corrected visual acuity (BCVA). Results: Five of the eight patients completed the 6-month follow-up. For all 5 patients, the changes in BCVA from baseline to 3 months were not statistically significant (P=0.070). Similarly, the change in BCVA from baseline to 6 months was not statistically significant (P=1.0). The mean CRT at baseline was 692 mu m. The changes from baseline to 3 months were not statistically significant (P=0.466); the changes from baseline to 6 months were also not statistically significant (P=0.808). We did not observe any ocular or systemic adverse effects. Conclusions: Intravitreal adalimumab showed no efficacy in improving BCVA or reducing CRT in patients with chronic uveitic macular edema. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article. Ophthalmology 2010; 117: 1612-1616 (C) 2010 by the American Academy of Ophthalmology.