Successful treatment of cystoid macular edema with etanercept in a patient with rheumatoid arthritis associated panuveitis

BACKGROUND: The anti-tumor necrosis factor (TNF)-alpha agent has been shown to be effective for the treatment of various inflammatory diseases, including rheumatoid arthritis and inflammatory disorders of the colon. It also appears to be effective for treatment of macular edema secondary to uveitis. CASE: A 57-year-old woman complained of blurred vision in both eyes. Inflammatory cells in the anterior chamber, vitreous opacity, and cystoid macular edema (CME) were detected in both eyes. Her corrected visual acuity was 0.1 OD and 0.3 OS. Macular thickness measured by optical coherence tomography was 784 and 714 microm for the right and left eyes, respectively. She had active rheumatoid arthritis, and treatment with etanercept was started. The extent of CME decreased gradually after the treatment was begun, with the macular thickness having decreased to 204 and 190 microm in the right and left eyes, respectively, and visual acuity having improved to 0.9 OD and 1.2 OS by 4 months after the beginning of treatment. CONCLUSION: These results suggest that etanercept may be effective for the treatment of CME secondary to uveitis, and they implicate TNF-a in the pathogenesis of uveitic CME.