ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 0199

Rapid Improvement in Cystoid Macular Edema with High Dose Intravenous Methylprednisolone in Non-Infectious Uveitis of Different Immune Mediated Inflammatory Diseases

Nuria Vegas-Revenga1, José Luis Martin-Varillas2, Vanesa Calvo-Río3, Iñigo Gonzalez-Mazon4, Lara Sánchez-Bilbao5, Emma Beltrán Catalán6, Alejandro Fonollosa7, Ana Blanco8, Ana Blanco9, Miguel Cordero Coma10, Norberto Ortego11, Ignacio Torre12, Felix Hernandez13, Santiago Muñóz-Fernández14, Maria del Mar Esteban-Ortega14, Manuel Diaz-Llopis15, Joaquin Cañal5, Juan Antonio Ventosa5, Rosalía Demetrio-Pablo16, Lucia Cristina Dominguez Casas17, Santos Castañeda18, Iván Ferraz-Amaro19, Miguel Ángel gonzalez-Gay20 and Ricardo Blanco3, 1Hospital Galdakao, Galdakao, Spain, 2Hospital Sierrallana, Torrelavega, Spain, 3Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain, 4H. U. Marques de Valdecilla, Santander, Spain, 5Hospital Universitario Marqués de Valdecilla, Santander, Spain, 6Hospital del Mar, Barcelona, Spain, 7Hospital Universitario de Cruces, Barakaldo, Spain, 8Hospital Universitario de Donostia, San Sebastián, 9Hospital Universitario de Donostia, Donostia, Spain, 10Hospital de León, Leon, Spain, 11Medicine Department, Universidad de Granada, Granada, Spain, 12Hospital Universitario de Basurto, Bilbao, Spain, 13Hospital Doctor Negrín, Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain, 14Hospital Universitario Infanta Sofia, Madrid, Spain, 15Hospital Universitario La Fe, Valencia, Spain, 16Hospital Universitario de Marqués de Valdecilla, Santander, Spain, 17Hospital Universtario San Agustin, Oviedo, Spain, 18Hospital Universitario de la Princesa, Madrid, Spain, 19Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain, 20Research group on Genetic Epidemiology and Atherosclerosis in Systemic Diseases and in Metabolic Bone Diseases of the Musculoskeletal System, IDIVAL, Division of Rheumatology, Hospital Universitario Marqués de Valdecilla; School of Medicine, Universidad de Cantabria, Santander, Spain. Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

Meeting: ACR Convergence 2021

Keywords: , ,

Session Information

Date: Saturday, November 6, 2021

Session Title: Miscellaneous Rheumatic & Inflammatory Diseases Poster I (0183–0209)

Session Type: Poster Session A

Session Time: 8:30AM-10:30AM

Background/Purpose: Cystoid Macular Edema (CME) is the most important cause of blindness in non-infectious uveitis (NIU) (1). Corticosteroids and conventional and/or biological immunosuppressant may be required (1-6). High-dose intravenous methylprednisolone (IVMP) pulse therapy may induce a rapid improvement.

The objective is to evaluate the efficacy and safety of IVMP pulse therapy in CME of different immune mediated inflammatory diseases (IMID).

Methods: Multicentre study of 66 patients with severe ocular inflammation who received IVMP. The underlying diseases were: Vogt-Koyanagi-Harada disease (VKHD)(n=24), Behçet’s disease (BD) (19) and idiopathic NIU (23). The main outcome variable was macular thickness and macular edema (Optical coherence tomography [OCT] >300 μm); that was assessed at 0 (basal), 2-5, 7, 15 and 30 days after IVMP. The results are expressed as mean ±SD for normally distributed variables, or as median [IQR] when are not. Comparison of continuous variables was performed using the Wilcoxon test.

Results: We studied 43♀/ 23♂ patients. The main features are shown in TABLE. IVMP dose ranged from 250 to 1000 mg/day administered for 3-5 consecutive days, the dose was established according to the presence or not of other systemic manifestations apart from uveitis. All of them had active intraocular inflammation at the moment of the study. A rapid and maintained statistically improvement was observed in OCT values in all underlying diseases (FIGURE). No major side effects were observed.

Conclusion: High-dose IVMP pulse therapy is useful and safe in the prompt control of CME, regardless of the underlying IMID.

REFERENCES
1. Vegas-Revenga N, et al. Am J Ophthalmol. 2019; 200:85-94. doi: 10.1016/j.ajo.2018.12.019
2. Calvo-Río V, et al. Clin Exp Rheumatol. 2014;32(4 Suppl 84): S54-7. PMID: 25005576
3. Santos-Gómez M, et al. Clin Exp Rheumatol. 2016;34(6 Suppl 102): S34-S40. PMID:27054359
4. Atienza-Mateo B, et al. Rheumatology (Oxford) 2018;57(5):856-864. doi: 10.1093/rheumatology/kex480.
5. Atienza-Mateo B, et al. Arthritis Rheumatol. 2019; 71(12):2081-2089. doi: 10.1002/art.41026.
6. Martín-Varillas JL, et al. Ophthalmology. 2018;125(9):1444-1451. doi: 10.1016/j.ophtha.2018.02.020

Table. Main features of 66 patients with cystoid macular edema.

Figure. Improvement of OCT in 66 patients with cystoid macular edema

Disclosures: N. Vegas-Revenga, None; J. Martin-Varillas, None; V. Calvo-Río, None; I. Gonzalez-Mazon, None; L. Sánchez-Bilbao, None; E. Beltrán Catalán, None; A. Fonollosa, None; A. Blanco, None; A. Blanco, None; M. Cordero Coma, None; N. Ortego, None; I. Torre, None; F. Hernandez, None; S. Muñóz-Fernández, None; M. Esteban-Ortega, None; M. Diaz-Llopis, None; J. Cañal, None; J. Ventosa, None; R. Demetrio-Pablo, None; L. Dominguez Casas, None; S. Castañeda, None; I. Ferraz-Amaro, None; M. gonzalez-Gay, None; R. Blanco, Brystol Myers Squibb, 6.

To cite this abstract in AMA style:

Vegas-Revenga N, Martin-Varillas J, Calvo-Río V, Gonzalez-Mazon I, Sánchez-Bilbao L, Beltrán Catalán E, Fonollosa A, Blanco A, Blanco A, Cordero Coma M, Ortego N, Torre I, Hernandez F, Muñóz-Fernández S, Esteban-Ortega M, Diaz-Llopis M, Cañal J, Ventosa J, Demetrio-Pablo R, Dominguez Casas L, Castañeda S, Ferraz-Amaro I, gonzalez-Gay M, Blanco R. Rapid Improvement in Cystoid Macular Edema with High Dose Intravenous Methylprednisolone in Non-Infectious Uveitis of Different Immune Mediated Inflammatory Diseases [abstract]. Arthritis Rheumatol. 2021; 73 (suppl 9). https://acrabstracts.org/abstract/rapid-improvement-in-cystoid-macular-edema-with-high-dose-intravenous-methylprednisolone-in-non-infectious-uveitis-of-different-immune-mediated-inflammatory-diseases/. Accessed January 27, 2023.

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