Anti-tumour necrosis factor medication for treating swelling at the back of the eye (macular oedema) due to inflammatory eye disease (uveitis)

Citation: Barry  RJ, Tallouzi  MO, Bucknall  N, Mathers  JM, Murray  PI, Calvert  MJ, Moore  DJ, Denniston  AK. Anti‐tumour necrosis factor biological therapies for the treatment of uveitic macular oedema (UMO) for non‐infectious uveitis. Cochrane Database of Systematic Reviews 2018, Issue 12. Art. No.: CD012577. DOI: 10.1002/14651858.CD012577.pub2.

What is the aim of this review?
The aim of this Cochrane was to find out whether a new class of drugs (anti-tumour necrosis factor agents) is effective in treating swelling at the back of the eye (macular oedema) caused by inflammation in the eye (uveitis). Cochrane Review authors searched for all relevant studies to address this question, but found no suitable studies for inclusion.

Key messages
There is currently no evidence for or against the use of anti-tumour necrosis factor agents in the treatment of macular oedema in uveitis.

What was studied in the review?
Uveitis is a group of eye conditions where there is inflammation within the eye. If there is inflammation at the back of the eye (macula) this can cause swelling (macular oedema). Macula oedema can lead to loss of vision.

Uveitis is often treated with steroids to control the inflammation and avoid damage to the eye. But steroids have potentially serious side effects, and doctors do not recommend long-term use. 'Steroid-sparing agents' are medications with similar anti-inflammatory effects to steroids, but with fewer side effects. They are preferred when people with uveitis need long-term treatment. Anti-tumour necrosis factor agents are a new type of steroid-sparing agent. They have been used for other conditions. Cochrane researchers wanted to find out if these agents are useful in the treatment of macular oedema in uveitis.

What are the main results of the review?
Cochrane Review authors searched multiple electronic databases for studies of the use of anti-tumour necrosis factor medications in macular oedema due to uveitis. They found no relevant studies. There are some studies that show that these drugs are effective in controlling inflammation in the eye, but none of these specifically investigated macular oedema. More research is needed to help informed decision-making in this area.

How up-to-date is this review?
Cochrane Review authors searched for studies that had been published up to 29 March 2018.