AIM:To evaluate the efficacy and safety of methazolamide in treating refractory uveitic macular edema.

METHODS: Retrospective self-controlled study was designed. A total of 15 patients(20 eyes)with refractory uveitic macular edema which used methazolamide as adjuvant therapy were enrolled in Shanghai First People's Hospital from January 2015 to June 2016. The changes of central macular thickness(CMT)and best corrected visual acuity(BCVA)were observed at baseline and 2, 4, 8wk after treatment. We also focused on the incidence of complications and relapse.

RESULTS: The CMT was 445.95±154.10μm, 338.83±138.34μm, 251.50±40.20μm, 244.90±35.68μm at baseline, 2, 4 and 8wk after treatment, respectively. The differences among them were statistically significant(F=15.467, P<0.05). The BCVA(log MAR)were 0.40±0.17, 0.28±0.21, 0.19±0.20, 0.18±0.21 at baseline, 2, 4 and 8wk respectively, with a significant difference among them(F=5.208, P<0.05). When the cumulative dose reached to 700mg and 1400mg, no one had methazolamide-related complications; and when it came to 2800mg, 5 patients(33%)had methazolamide-related complication. After the withdrawal of methazolamide 1wk, 1 and 3mo, 3 patients(20%), 5 patients(33%)and 8 patients(53%)relapsed, respectively.

CONCLUSION: Methazolamide is beneficial in improving macular edema and vision in 4wk. When the cumulative dose is more than 1400mg, we need pay attention to the complications. After discontinuing methazolamide for 1wk, macular edema relapsed in some patients, and more than half of patients recurred after 3mo. So the patients should be followed closely in 3mo after withdrawal of methazolamide.