AIM:To evaluate the effects and safety of intravitreal injection of Ranibizumab on noninfectious uveitic macular edema(UME).

METHODS: This was an open and prospective study without control trial. Seventeen eyes from 17 patients with UME diagnosed by fundus fluorescein angiography(FFA)and optical coherence tomography(OCT)were enrolled in this study. Before the injection, best-corrected visual acuity(BCVA)of early treatment of diabetic retinopathy study(ETDRS)and central macular thickness(CMT)measured by OCT were examined. All affected eyes were treated with intravitreal ranibizumab 0.05mL(0.5mg). The BCVA, CMT and intraocular pressure(IOP)were compared with baseline at 2, 4, 8 and 12wk after treatment. Related complications were recorded.

RESULTS: The median BCVA before treatment was 57(P₂₅ and P₇₅ were 52.5 and 64.5, respectively). The median CMT was 524μm(P₂₅ and P₇₅ were 365.5 and 571, respectively). At 2, 4, 8, and 12wk after injection, the median BCVA of the affected eyes was 76(P₂₅ and P₇₅ were 71 and 80, respectively), 81(P₂₅ and P₇₅ were 78.5 and 83, respectively), 82(P₂₅ and P₇₅ were 68.5 and 84, respectively), and 82(P₂₅ and P₇₅ are 78.5 and 83, respectively). The Friedman M test showed that there were differences in the BCVA in the four groups at different follow-up times, that was, BCVA after injection was higher than before injection(χ²=47.58, P<0.01). At 2, 4, 8, and 12wk after injection, the median CMT was 307μm(P₂₅ and P₇₅ were 249.5 and 374.5, respectively),231μm(P₂₅ and P₇₅ were 212.5 and 267), 219μm(P₂₅ and P₇₅ were 210.5 and 365.5,respectively), and 217μm(P₂₅ and P₇₅ were 201.5 and 366.5,respectively). The Friedman M test showed that there was difference in the CMT in the four groups at different follow-up times(χ²=40.33, P<0.01), that was, CMT after injection was lower than before injection. At the 12wk after injection, increased CMT and decreased BCVA were found in 35% of study eyes(6/17)that had uncontrolled intraocular inflammation, and all these patients needed to increase prednisone again. No adverse events were found during the follow-up duration.

CONCLUSION: Intravitreal ranibizumab is a safe and effective approach for noninfectious uveitic macular edema in the short term, which can significantly improve visual acuity and reduce CMT in patients refractory to or intolerant of standard corticosteroid/ immunomodulatory therapy.