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Journal of Ocular Pharmacology and... Aug 2003In the treatment of uveitis, corticosteroids are usually included in first-line therapy due to its rapid onset of action and excellent safety profile. Systemic... (Review)
Review
In the treatment of uveitis, corticosteroids are usually included in first-line therapy due to its rapid onset of action and excellent safety profile. Systemic immunosuppressive agents also play an important role in the management of posterior uveitis. The purpose of this study was to review systemic agents for treating uveitis: prednisone, methotrexate, cyclosporine, and azathioprine. This study was a review of the literature using Medline. Thirty-eight references were incorporated. Immunosuppressants take several weeks for their full effect and are considered when long-term therapy is anticipated. When long-term therapy is anticipated, immunosuppressant agents may be added, which allows for the reduction and eventual discontinuation of prednisone. Combination therapy of various immunosuppressants also allows for long-term therapy, which reduces the relapse rate. However, immunosuppressives can be associated with serious side-effects. The use of immunosuppressants requires careful monitoring.
Topics: Drug Therapy, Combination; Humans; Immunosuppressive Agents; MEDLINE; United States; Uveitis, Posterior
PubMed: 12964957
DOI: 10.1089/108076803322279381 -
Clinical & Experimental Ophthalmology Dec 2019
Topics: Dexamethasone; Humans; Uveitis; Uveitis, Posterior
PubMed: 31865643
DOI: 10.1111/ceo.13694 -
Journal of Ocular Pharmacology and... May 2017Uveitis is one of the fields in ophthalmology where a tremendous evolution took place in the past 25 years. Not only did we gain access to more efficient, more targeted,... (Review)
Review
Uveitis is one of the fields in ophthalmology where a tremendous evolution took place in the past 25 years. Not only did we gain access to more efficient, more targeted, and better tolerated therapies, but also in parallel precise and quantitative measurement methods developed allowing the clinician to evaluate these therapies and adjust therapeutic intervention with a high degree of precision. Objective and quantitative measurement of the global level of intraocular inflammation became possible for most inflammatory diseases with direct or spill-over anterior chamber inflammation, thanks to laser flare photometry. The amount of retinal inflammation could be quantified by using fluorescein angiography to score retinal angiographic signs. Indocyanine green angiography gave imaging insight into the hitherto inaccessible choroidal compartment, rendering possible the quantification of choroiditis by scoring indocyanine green angiographic signs. Optical coherence tomography has enabled measurement and objective monitoring of retinal and choroidal thickness. This multimodal quantitative appraisal of intraocular inflammation represents an exquisite security in monitoring uveitis. What is enigmatic, however, is the slow pace with which these improvements are integrated in some areas. What is even more difficult to understand is the fact that clinical trials to assess new therapeutic agents still mostly rely on subjective parameters such as clinical evaluation of vitreous haze as a main endpoint; whereas a whole array of precise, quantitative, and objective modalities are available for the design of clinical studies. The scope of this work was to review the quantitative investigations that improved the management of uveitis in the past 2-3 decades.
Topics: Anti-Inflammatory Agents, Non-Steroidal; Eye Infections; Humans; Inflammation; Uveitis, Posterior
PubMed: 27937751
DOI: 10.1089/jop.2016.0089 -
Romanian Journal of Ophthalmology 2022Anterior uveitis is the most common extra-articular manifestation in children diagnosed with Juvenile idiopathic arthritis (JIA). It is typically a non-granulomatous,...
Anterior uveitis is the most common extra-articular manifestation in children diagnosed with Juvenile idiopathic arthritis (JIA). It is typically a non-granulomatous, chronic, and asymptomatic uveitis. The lack of acute symptoms often delays the diagnosis with the incidence of severe ocular complications. Chorioretinitis lesions have been described in only 1% of cases. The absence of fundus changes can be explained by the impossibility of performing fundoscopy through the cloudy ocular media, secondary to inflammation. A 7-year-old female with a 3-month history of painless reduced vision came to have an eye examination. An initial diagnosis of bilateral anterior granulomatous uveitis complicated with glaucoma and cataract was formulated. Because of the concomitant diagnosis of COVID-19 disease (same day as the eye examination), the child was hospitalized in a hometown COVID-19 patient ward, so both local and general treatment, monitorization, and investigations were discontinued. The following eye examination revealed the persistence of anterior uveitis, inflammatory glaucoma, cataract, and the appearance of band keratopathy. Fundoscopy revealed numerous disseminated lesions of choroiditis. Further examinations established JIA-associated uveitis diagnosis, so systemic corticosteroids were initiated followed by Methotrexate and Adalimumab. . BVA = best visual acuity, CVA = corrected visual acuity, CS = corticosteroids, IOP = Intraocular pressure, JIA = Juvenile idiopathic arthritis, JIA-U = Juvenile idiopathic arthritis associated uveitis, LE = left eye, MTX = Methotrexate, OU = both eyes, OCT = Optical Coherence Tomography, RE = right eye, TNF = tumor necrosis factor.
Topics: Arthritis, Juvenile; COVID-19; Cataract; Child; Female; Glaucoma; Humans; Methotrexate; Uveitis; Uveitis, Anterior; Uveitis, Posterior
PubMed: 35935079
DOI: 10.22336/rjo.2022.36 -
Acta Ophthalmologica Feb 2020
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Female; Finland; Humans; Incidence; Male; Middle Aged; Tertiary Care Centers; Uveitis, Posterior; Young Adult
PubMed: 31273927
DOI: 10.1111/aos.14182 -
International Ophthalmology Clinics 1995
Review
Topics: Anterior Eye Segment; Diagnosis, Differential; Eye Diseases; Humans; Uveitis, Posterior
PubMed: 8964660
DOI: 10.1097/00004397-199503530-00003 -
International Ophthalmology Clinics 1995
Review
Topics: Eye Diseases; Fluorescein Angiography; Humans; Uveitis, Posterior
PubMed: 8964665
DOI: 10.1097/00004397-199503530-00005 -
Lancet (London, England) Jan 2017
Topics: Humans; Pregnancy Complications, Infectious; Uveitis, Posterior; Zika Virus; Zika Virus Infection
PubMed: 27939402
DOI: 10.1016/S0140-6736(16)32518-1 -
Indian Journal of Ophthalmology Sep 2017We describe a case of a 65-year old man diagnosed with retinal vasoproliferative tumour secondary to posterior uveitis. The fluorescein angiography shows an interesting...
We describe a case of a 65-year old man diagnosed with retinal vasoproliferative tumour secondary to posterior uveitis. The fluorescein angiography shows an interesting meteor-like leak emanating from the tumour and rising towards the superior retina in the later frames of the angiogram. Pictorially, we call it the "Retinal Meteor" and also describe the possible mechanism for this pattern of leakage.
Topics: Aged; Diagnosis, Differential; Fluorescein Angiography; Fundus Oculi; Humans; Male; Retinal Neoplasms; Retinal Vessels; Tomography, Optical Coherence; Uveitis, Posterior
PubMed: 28905838
DOI: 10.4103/ijo.IJO_68_17 -
Eye (London, England) 1998
Topics: Coloring Agents; Humans; Indocyanine Green; Uveitis, Posterior
PubMed: 10070504
DOI: 10.1038/eye.1998.198