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Optimising drug therapy for non-infectious uveitis

International Ophthalmology volume 39, pages 1633–1650 (2019)Cite this article

Abstract

Introduction

Uveitis encompasses a wide variety of sight-threatening diseases characterized by intraocular inflammation. It is often classified as infectious and non-infectious uveitis. Unlike infectious uveitis, a distinct infectious agent cannot be identified in non-infectious uveitis and disease origin is usually autoimmune, drug related, or idiopathic.

The Issue at Hand

Non-infectious uveitis can often have a relapsing-remitting course, making it difficult to treat, and poses a significant challenge to ophthalmologists. The autoimmune nature of non-infectious uveitis warrants the use of anti-inflammatory and immunomodulatory agents for disease control. However, a subset of patients has persistent or recurrent ocular inflammation despite appropriate treatment, stressing the need for newer therapies aimed at more specific inflammatory targets such as tumour necrosis factor (TNF) alpha agents, anti-interleukin agents, and anti-interleukin receptor agents.

Objectives

This article discusses the various medical options available for the treatment of non-infectious uveitis in the light of the most recent evidence.

Conclusion

Successful management of non-infectious uveitis requires the clinician carefully balance advantages and disadvantages of each new and old therapy while considering individual circumstances. Counselling regarding the benefits and complications of each therapy can help patients make an informed choice.

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  1. Aga Khan University, Karachi, Pakistan

    Mohammad Ali Shahab & Sidra Zafar

  2. Johns Hopkins Wilmer Eye Institute, Baltimore, USA

    Tahreem Aman Mir

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  1. Mohammad Ali Shahab
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Shahab, M.A., Mir, T.A. & Zafar, S. Optimising drug therapy for non-infectious uveitis. Int Ophthalmol 39, 1633–1650 (2019). https://doi.org/10.1007/s10792-018-0984-1

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Keywords

  • Anti-TNF
  • Biologics
  • Corticosteroids
  • Uveitis