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Purpose <p>Noninfectious uveitic macular edema (UME) is a major cause of visual impairment and remains challenging in refractory cases. Although adalimumab (ADA) is an effective biologic therapy, its delayed onset may limit early disease control, suggesting a potential role for bridging strategies such as local corticosteroid injection. This study compared ADA monotherapy with ADA combined with sub-Tenon’s triamcinolone acetonide (STTA) bridging therapy in refractory noninfectious UME.</p> Methods <p>In this retrospective longitudinal cohort study, 30 patients (44 eyes) with refractory noninfectious UME treated with ADA (2015–2025) were included. Patients received either ADA monotherapy or ADA with STTA bridging therapy. Outcomes included time to improvement (≥ 20% reduction in central subfield thickness (CST) with reduced cystoid spaces), relapse after resolution, longitudinal CST changes, best-corrected visual acuity (BCVA, LogMAR), and intraocular pressure (IOP). Time-to-event analyses were performed using Cox regression, and Longitudinal data using generalized estimating equation models adjusted for baseline covariates.</p> Results <p>Bridging therapy was associated with a shorter time to improvement (log-rank <i>p</i> = 0.008; HR 2.850, 95% CI 1.402–5.794; <i>p</i> = 0.004). Adjusted analyses showed greater visual improvement in the bridging group at 12 months (difference 0.307 LogMAR; <i>p</i> &lt; 0.001) and at 15, 24, and 36 months (<i>p</i> &lt; 0.05). Greater CST reductions were observed at 3, 18, 21, and 36 months (<i>p</i> &lt; 0.05). Relapse risk did not differ significantly (HR 0.711, 95% CI 0.155–3.272; <i>p</i> = 0.662). IOP changes were generally comparable.</p> Conclusion <p>ADA combined with STTA bridging therapy was associated with earlier anatomical improvement and additional visual benefits compared with ADA monotherapy, without increased relapse risk.</p>

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Sub-Tenon’s triamcinolone bridging to adalimumab therapy in refractory noninfectious uveitic macular edema

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月17日

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  • Yaru Zou,
  • Mingming Yang,
  • Jing Zhang,
  • Yuan Zong,
  • Zizhen Ye,
  • Jiaxin Deng,
  • Wendong Gu,
  • Kyoko Ohno-Matsui,
  • Koju Kamoi

摘要

Purpose

Noninfectious uveitic macular edema (UME) is a major cause of visual impairment and remains challenging in refractory cases. Although adalimumab (ADA) is an effective biologic therapy, its delayed onset may limit early disease control, suggesting a potential role for bridging strategies such as local corticosteroid injection. This study compared ADA monotherapy with ADA combined with sub-Tenon’s triamcinolone acetonide (STTA) bridging therapy in refractory noninfectious UME.

Methods

In this retrospective longitudinal cohort study, 30 patients (44 eyes) with refractory noninfectious UME treated with ADA (2015–2025) were included. Patients received either ADA monotherapy or ADA with STTA bridging therapy. Outcomes included time to improvement (≥ 20% reduction in central subfield thickness (CST) with reduced cystoid spaces), relapse after resolution, longitudinal CST changes, best-corrected visual acuity (BCVA, LogMAR), and intraocular pressure (IOP). Time-to-event analyses were performed using Cox regression, and Longitudinal data using generalized estimating equation models adjusted for baseline covariates.

Results

Bridging therapy was associated with a shorter time to improvement (log-rank p = 0.008; HR 2.850, 95% CI 1.402–5.794; p = 0.004). Adjusted analyses showed greater visual improvement in the bridging group at 12 months (difference 0.307 LogMAR; p < 0.001) and at 15, 24, and 36 months (p < 0.05). Greater CST reductions were observed at 3, 18, 21, and 36 months (p < 0.05). Relapse risk did not differ significantly (HR 0.711, 95% CI 0.155–3.272; p = 0.662). IOP changes were generally comparable.

Conclusion

ADA combined with STTA bridging therapy was associated with earlier anatomical improvement and additional visual benefits compared with ADA monotherapy, without increased relapse risk.