0 100 200 300 400 500 600 700 0.00 0.10 0.20 0.30 0.40 0.50 0.60 0 2 4 6 8 10 12 14 16 18 20 Treatment today is complex: MESI can persist and recur despite inflammation resolution and multiple therapies Months CST Visual Acuity 20/20 20/25 20/32 20/40 20/50 20/63 20/80 This representative case is based on Dr. Quan Nguyen’s clinical experience, literature, and reviewed by uveitis consultants. Int Med Case Rep J. 2025 Mar30;18:445-460. J Ophthalmic Inflamm Infect 2025 Mar 13;15(1):25; Clin Ophthalmol. 2013 Dec 18;8:73-81 Multiple systemic therapies to control inflammation • Initiate oral prednisone 60 mg, significant weight gain • Oral prednisone tapered, and methotrexate (MTX) added Macular edema develops despite Control of inflammation • Received 3 cycles of monthly IV methylprednisone due to MESI • Started adalimumab, discontinued due to cutaneous reaction • Switched to mycophenolate mofetil 1500mg BID Vision drops and MESI persists; introduce 1 st Ozurdex MESI temporarily responds to Ozurdex Fluid reoccurs; 2 nd dose of Ozurdex Cataract developed and fluid reoccurs; 3 rd dose of Ozurdex VA CST Fluid responded, but patient needed a combined glaucoma and cataract surgery MESI temporarily responds to Ozurdex Both eyes underwent a similar clinical course, only right eye is shown here 106