Skip to main content

Advertisement

Log in

Chronic Non-Infectious Uveitis in the Elderly

Epidemiology, Pathophysiology and Management

  • Therapy In Practice
  • Published:
Drugs & Aging Aims and scope Submit manuscript

Abstract

Intraocular inflammatory diseases are collectively known as uveitis. The aetiology of this condition can be diverse, as inflammation may result from direct involvement of the uveal tract or indirect inflammation of adjacent tissues. Uveitis can present challenges to diagnosis and treatment, and is potentially a severe sight-threatening disease. In the elderly, uveitis can present de novo after the age of 60 years or may represent a process earlier in life continuing after the age of 60 years, although many cases will have become quiescent by that time. More recent studies suggest that uveitis presenting after 60 years of age is more common than previously believed. Most cases of uveitis are of unknown aetiology and are classed as idiopathic, although sarcoidosis, ocular ischaemia and birdshot chorioretinopathy are recognised non-infectious causes of uveitis in the elderly. Systemic immunosuppression, with its well known complications, may be required to preserve vision. In this age group, one should always have high suspicion of a masquerade syndrome, particularly a primary CNS non-Hodgkin’s lymphoma. With the demographics of the elderly population changing and mean life expectancy increasing, it is important that clinicians are familiar with uveitis as a potential cause of visual impairment in this age group.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Table I
Table II
Table III
Table IV
Table V
Table VI
Table VII

Similar content being viewed by others

References

  1. Bloch-Michel E, Nussenblatt RB. International Uveitis Study Group recommendations for the evaluation of intraocular inflammatory disease. Am J Ophthalmol 1987 Feb 15; 103(2): 234–5

    PubMed  CAS  Google Scholar 

  2. Durrani OM, Meads CA, Murray PI. Uveitis: a potentially blinding disease. Ophthalmologica 2004 Jul–Aug; 218(4): 223–36

    Article  PubMed  CAS  Google Scholar 

  3. Jabs DA, Nussenblatt RB, Rosenbaum JT. Standardization of uveitis nomenclature for reporting clinical data: results of the First International Workshop. Am J Ophthalmol 2005 Sep; 140(3): 509–16

    Article  PubMed  Google Scholar 

  4. Proposed clinical classification of uveitis. International Uveitis Study Group, 2006. (Data on file)

  5. Chang JH, Wakefield D. Uveitis: a global perspective. Ocul Immunol Inflamm 2002 Dec; 10(4): 263–79

    Article  PubMed  Google Scholar 

  6. Rothova A, van Veenedaal WG, Linssen A, et al. Clinical features of acute anterior uveitis. Am J Ophthalmol 1987 Feb 15; 103(2): 137–45

    PubMed  CAS  Google Scholar 

  7. Suhler Martin TM, Rosenbaum JT. HLA-B27-associated uveitis: overview and current perspectives. Curr Opin Ophthalmol 2003 Dec; 14(6): 378–83

    Article  Google Scholar 

  8. Martin TM, Smith JR, Rosenbaum JT. Anterior uveitis: current concepts of pathogenesis and interactions with the spondyloar-thropathies. Curr Opin Rheumatol 2002 Jul; 14(4): 337–41

    Article  PubMed  Google Scholar 

  9. Wakefield D, Chang JH. Epidemiology of uveitis. Int Ophthalmol Clin 2005 Spring; 45(2): 1–13

    Article  PubMed  Google Scholar 

  10. Darreil RW, Wagener HP, Kurland LT. Epidemiology of uveitis: incidence and prevalence in a small urban community. Arch Ophthalmol 1962 Oct; 68: 502–14

    Article  Google Scholar 

  11. Henderly DE, Genstler AJ, Smith RE, et al. Changing patterns of uveitis. Am J Ophthalmol 1987 Feb 15; 103(2): 131–6

    PubMed  CAS  Google Scholar 

  12. Weiner A, BenEzra D. Clinical patterns and associated conditions in chronic uveitis. Am J Ophthalmol 1991 Aug 15; 112(2): 151–8

    PubMed  CAS  Google Scholar 

  13. Perkins ES, Folk J. Uveitis in London and Iowa. Ophthalmologica 1984; 189(1–2): 36–40

    Article  PubMed  CAS  Google Scholar 

  14. Menezo V, Lightman S. The development of complications in patients with chronic anterior uveitis. Am J Ophthalmol 2005 Jun; 139(6): 988–92

    Article  PubMed  Google Scholar 

  15. McCluskey PJ, Towler HM, Lightman S. Management of chronic uveitis. BMJ 2000 Feb 26; 320(7234): 555–8

    Article  PubMed  CAS  Google Scholar 

  16. Whallett AJ, Thurairajan G, Hamburger J, et al. Behçet’s syndrome: a multidisciplinary approach to clinical care. QJM 1999 Dec; 92(12): 727–40

    Article  PubMed  CAS  Google Scholar 

  17. Rothova A. Ocular involvement in sarcoidosis. Br J Ophthalmol 2000 Jan; 84(1): 110–6

    Article  PubMed  CAS  Google Scholar 

  18. Jones NP. Fuchs’ heterochromic uveitis: an update. Surv Ophthalmol 1993 Jan–Feb; 37(4): 253–72

    Article  PubMed  CAS  Google Scholar 

  19. Bonfioli AA, Curi AL, Orefice F. Fuchs’ heterochromic cyclitis. Semin Ophthalmol 2005 Jul–Sep; 20(3): 143–6

    Article  PubMed  Google Scholar 

  20. Moorthy RS, Mermoud A, Baerveldt G, et al. Glaucoma associated with uveitis. Surv Ophthalmol 1997 Mar–Apr; 41(5): 361–94

    Article  PubMed  CAS  Google Scholar 

  21. Thach AB, Marak Jr GE, McLean IW, et al. Phacoanaphylactic endophthalmitis: a clinicopathologic review. Int Ophthalmol 1991 Jul; 15(4): 271–9

    Article  PubMed  CAS  Google Scholar 

  22. Stavrou P, Mitchell SM, Fox JD, et al. Detection of varicella-zoster virus DNA in ocular samples from patients with uveitis but no cutaneous eruption. Eye 1994; 8 Pt 6: 684–7

    Article  PubMed  Google Scholar 

  23. Bonfioli AA, Damico FM, Curi AL, et al. Intermediate uveitis. Semin Ophthalmol 2005 Jul–Sep; 20(3): 147–54

    Article  PubMed  Google Scholar 

  24. Boyd SR, Young S, Lightman S. Immunopathology of the noninfectious posterior and intermediate uveitides. Surv Ophthalmol 2001 Nov–Dec; 46(3): 209–33

    Article  PubMed  CAS  Google Scholar 

  25. Jones NP. Sarcoidosis and uveitis. Ophthalmol Clin North Am 2002 Sep; 15(3): 319–26, vi

    Article  PubMed  Google Scholar 

  26. Pavesio CE, Lightman S. Toxoplasma gondii and ocular toxo-plasmosis: pathogenesis. Br J Ophthalmol 1996 Dec; 80(12): 1099–107

    Article  PubMed  CAS  Google Scholar 

  27. Shah KH, Levinson RD, Yu F, et al. Birdshot chorioretinopathy. Surv Ophthalmol 2005 Nov–Dec; 50(6): 519–41

    Article  PubMed  Google Scholar 

  28. Office for National Statistics. Population estimates: UK population approaches 60 million [online]. Available from URL: http://www.statistics.gov.uk/CCI/nugget.asp?.ID=6 [Accessed 2006 Feb 15]

  29. Dandona L, Dandona R, John RK, et al. Population based assessment of uveitis in an urban population in southern India. Br J Ophthalmol 2000 Jul; 84(7): 706–9

    Article  PubMed  CAS  Google Scholar 

  30. Guex-Crosier Y. Epidemiology of uveitis [in French]. Rev Prat 1999 Nov 15; 49(18): 1989–94

    PubMed  CAS  Google Scholar 

  31. Barton K, Pavesio CE, Towler HM, et al. Uveitis presenting de novo in the elderly. Eye 1994; 8 (Pt 3): 288–91

    Article  PubMed  Google Scholar 

  32. Favre C, Tran VT, Herbort CP. Uveitis in the elderly [in French]. Klin Monatsbl Augenheilkd 1994 May; 204(5): 319–22

    Article  PubMed  CAS  Google Scholar 

  33. Gritz DC, Wong IG. Incidence and prevalence of uveitis in Northern California: the Northern California Epidemiology of Uveitis Study. Ophthalmology 2004 Mar; 111(3): 491–500

    Article  PubMed  Google Scholar 

  34. Reeves SW, Sloan FA, Lee PP, et al. Uveitis in the elderly: epidemiological data from the National Long-term Care Survey Medicare Cohort. Ophthalmology 2006 Feb; 113(2): 307, e1

    Article  PubMed  Google Scholar 

  35. Tran VT, Auer Guex-Crosier Y, et al. Epidemiological characteristics of uveitis in Switzerland. Int Ophthalmol 1994; 18(5): 293–8

    Article  PubMed  Google Scholar 

  36. Makley Jr TA, Orlando RG. Uveitis in older patients. Ann Ophthalmol 1982 Oct; 14(10): 942–4

    PubMed  Google Scholar 

  37. Rodriguez A, Calonge M, Pedroza-Seres M, et al. Referral patterns of uveitis in a tertiary eye care center. Arch Ophthalmol 1996 May; 114(5): 593–9

    Article  PubMed  CAS  Google Scholar 

  38. Gilbert RE, Dunn DT, Lightman S, et al. Incidence of symptomatic toxoplasma eye disease: aetiology and public health implications. Epidemiol Infect 1999 Oct; 123(2): 283–9

    Article  PubMed  CAS  Google Scholar 

  39. Sullivan C, Murray PI. Acquired ocular toxoplasmosis in an elderly patient. Eye 2001 Dec; 15 (Pt 6): 791–2

    Article  PubMed  CAS  Google Scholar 

  40. Chatzistefanou K, Markomichelakis NN, Christen W, et al. Characteristics of uveitis presenting for the first time in the elderly. Ophthalmology 1998 Feb; 105(2): 347–52

    Article  PubMed  CAS  Google Scholar 

  41. Becker MD, Smith JR, Max R, et al. Management of sight-threatening uveitis: new therapeutic options. Drugs 2005; 65(4): 497–519

    Article  PubMed  CAS  Google Scholar 

  42. Forrester JV. Uveitis: pathogenesis. Lancet 1991 Dec 14; 338(8781): 1498–501

    Article  PubMed  CAS  Google Scholar 

  43. Lightman S. Uveitis: what do we know and how does it help? Clin Experiment Ophthalmol 2001 Apr; 29(2): 48–51

    Article  PubMed  CAS  Google Scholar 

  44. Whitcup SM, Nussenblatt RB. Immunologic mechanisms of uveitis: new targets for immunomodulation. Arch Ophthalmol 1997 Apr; 115(4): 520–5

    Article  PubMed  CAS  Google Scholar 

  45. Dick AD. Immune mechanisms of uveitis: insights into disease pathogenesis and treatment. Int Ophthalmol Clin 2000 Spring; 40(2): 1–18

    Article  PubMed  CAS  Google Scholar 

  46. Durrani OM, Curnow SJ, Faint JM, et al. Enumeration, characterisation and clinical correlation of cellular infiltrate in uveitis [abstract no. 3067]. Invest Ophthmol Vis Sci 2001; 42(4): S571

    Google Scholar 

  47. Curnow SJ, Faint JM, Durrani OM, et al. CD4+ and CD8+ lymphocytes of naive and memory phenotype in uveitis [abstract no. 4940]. Invest Ophthalmol Vis Sci 2001; 42(2): S919

    Google Scholar 

  48. Murray PI, Clay CD, Mappin C, et al. Molecular analysis of resolving immune responses in uveitis. Clin Exp Immunol 1999 Sep; 117(3): 455–61

    Article  PubMed  CAS  Google Scholar 

  49. Murray PI, Young DW. Soluble interleukin-2 receptors in retinal vasculitis. Curr Eye Res 1992; 11 Suppl.: 193–5

    Article  PubMed  Google Scholar 

  50. Sugi-Ikai N, Nakazawa M, Nakamura S, et al. Increased frequencies of interleukin-2- and interferon-gamma-producing T cells in patients with active Behçet’s disease. Invest Ophthalmol Vis Sci 1998 May; 39(6): 996–1004

    PubMed  CAS  Google Scholar 

  51. Dick AD, Cheng YF, Purdie AT, et al. Immunocytochemical analysis of blood lymphocytes in uveitis. Eye 1992; 6 (Pt 6): 643–7

    Article  PubMed  Google Scholar 

  52. Dick AD, Siepmann K, Dees C, et al. Fas-Fas ligand-mediated apoptosis within aqueous during idiopathic acute anterior uveitis. Invest Ophthalmol Vis Sci 1999 Sep; 40(10): 2258–67

    PubMed  CAS  Google Scholar 

  53. Curnow SJ, Rauz S, Durrani OM, et al. Inhibition of spontaneous lymphocyte apoptosis contributes to the breakdown of immune privilege in uveitis [abstract]. In: Annual meeting abstract search and program planner (on CD-ROM). Association for Research in Vision and Ophthalmology 2002, 1535

    Google Scholar 

  54. Streilein JW, Taylor AW. Local immunosuppression: the eye. In: Thompson A, editor. Therapeutic immunosuppression (immunology and medicine series). Dordrecht: Kluwer Academic, 2001: 275–322

    Chapter  Google Scholar 

  55. Streilein JW. Ocular immune privilege: therapeutic opportunities from an experiment of nature. Nat Rev Immunol 2003 Nov; 3(11): 879–89

    Article  PubMed  CAS  Google Scholar 

  56. Griffith TS, Brunner T, Fletcher SM, et al. Fas ligand-induced apoptosis as a mechanism of immune privilege. Science 1995 Nov 17; 270(5239): 1189–92

    Article  PubMed  CAS  Google Scholar 

  57. Streilein JW. Ocular immune privilege: the eye takes a dim but practical view of immunity and inflammation. J Leukoc Biol 2003 Aug; 74(2): 179–85

    Article  PubMed  CAS  Google Scholar 

  58. Curnow SJ, Scheel-Toellner D, Jenkinson W, et al. Inhibition of T cell apoptosis in the aqueous humor of patients with uveitis by IL-6/soluble IL-6 receptor trans-signaling. J Immunol 2004 Oct 15; 173(8): 5290–7

    PubMed  CAS  Google Scholar 

  59. Murray PI, Hoekzema R, van Haren MA, et al. Aqueous humor interleukin-6 levels in uveitis. Invest Ophthalmol Vis Sci 1990 May; 31(5): 917–20

    PubMed  CAS  Google Scholar 

  60. Curnow SJ, Falciani F, Durrani OM, et al. Multiplex bead immunoassay analysis of aqueous humor reveals distinct cytokine profiles in uveitis. Invest Ophthalmol Vis Sci 2005 Nov; 46(11): 4251–9

    Article  PubMed  Google Scholar 

  61. Kirsch O, Lautier-Frau M, Labetoulle M, et al. Characteristics of uveitis presenting de novo in the elderly [in French]. J Fr Ophtalmol 2003 Sep; 26(7): 720–4

    PubMed  CAS  Google Scholar 

  62. Ikeda N, Hayasaka S, Hayasaka Y. Uveitis and pseudouveitis presenting for the first time in Japanese elderly patients. Ophthalmologica 2005 Sep–Oct; 219(5): 263–6

    Article  PubMed  Google Scholar 

  63. Jacobs NA, Ridgway AE. Syndrome of ischaemic ocular inflammation: six cases and a review. Br J Ophthalmol 1985 Sep; 69(9): 681–7

    Article  PubMed  CAS  Google Scholar 

  64. Malhotra R, Gregory-Evans K. Management of ocular ischaemic syndrome. Br J Ophthalmol 2000 Dec; 84(12): 1428–31

    Article  PubMed  CAS  Google Scholar 

  65. Rothwell PM, Warlow CP. Prediction of benefit from carotid endarterectomy in individual patients: a risk-modelling study. European Carotid Surgery Trialists’ Collaborative Group. Lancet 1999 Jun 19; 353(9170): 2105–10

    Article  PubMed  CAS  Google Scholar 

  66. Rothova A, Meenken C, Michels RP, et al. Uveitis and diabetes mellitus. Am J Ophthalmol 1988 Jul 15; 106(1): 17–20

    Article  PubMed  CAS  Google Scholar 

  67. Murray PI, Russell-Eggitt IM. An unusual presentation of diabetes mellitus. Metab Pediatr Syst Ophthalmol 1991; 14(1): 16–7

    PubMed  CAS  Google Scholar 

  68. Joslin EP. Joslin’s diabetes mellitus. 12th ed. Philadelphia (PA): Lea & Febiger, 1985

    Google Scholar 

  69. Read RW, Zamir E, Rao NA. Neoplastic masquerade syndromes. Surv Ophthalmol 2002 Mar–Apr; 47(2): 81–124

    Article  PubMed  Google Scholar 

  70. Levy-Clarke GA, Chan CC, Nussenblatt RB. Diagnosis and management of primary intraocular lymphoma. Hematol Oncol Clin North Am 2005 Aug; 19(4): 739–49, viii

    Article  PubMed  Google Scholar 

  71. Freeman LN, Schachat AP, Knox DL, et al. Clinical features, laboratory investigations, and survival in ocular reticulum cell sarcoma. Ophthalmology 1987 Dec; 94(12): 1631–9

    PubMed  CAS  Google Scholar 

  72. Stanbury RM, Graham EM, Murray PI. Sarcoidosis. Int Ophthalmol Clin 1995 Summer; 35(3): 123–37

    Article  PubMed  CAS  Google Scholar 

  73. Lardenoye CW, Van der Lelij A, de Loos WS, et al. Peripheral multifocal chorioretinitis: a distinct clinical entity? Ophthalmology 1997 Nov; 104(11): 1820–6

    PubMed  CAS  Google Scholar 

  74. McCluskey P, Powell RJ. The eye in systemic inflammatory diseases. Lancet 2004 Dec 11–17; 364(9451): 2125–33

    Article  PubMed  Google Scholar 

  75. Edelsten Pearson A, Joynes E, et al. The ocular and systemic prognosis of patients presenting with sarcoid uveitis. Eye 1999 Dec; 13 (Pt 6): 748–53

    Article  PubMed  Google Scholar 

  76. Stavrou P, Linton S, Young DW, et al. Clinical diagnosis of ocular sarcoidosis. Eye 1997; 11 (Pt 3): 365–70

    Article  PubMed  Google Scholar 

  77. Kaiser PK, Lowder CY, Sullivan P, et al. Chest computerized tomography in the evaluation of uveitis in elderly women. Am J Ophthalmol 2002 Apr; 133(4): 499–505

    Article  PubMed  Google Scholar 

  78. Sobrin L, Lam BL, Liu M, et al. Electroretinographic monitoring in birdshot chorioretinopathy. Am J Ophthalmol 2005 Jul; 140(1): 52–64

    Article  PubMed  Google Scholar 

  79. Holder GE, Robson AG, Pavesio C, et al. Electrophysiological characterisation and monitoring in the management of birdshot chorioretinopathy. Br J Ophthalmol 2005 Jun; 89(6): 709–18

    Article  PubMed  CAS  Google Scholar 

  80. Moorthy RS, Valluri S, Jampol LM. Drug-induced uveitis. Surv Ophthalmol 1998 May–Jun; 42(6): 557–70

    Article  PubMed  CAS  Google Scholar 

  81. Gatti D, Adami S. New bisphosphonates in the treatment of bone diseases. Drugs Aging 1999 Oct; 15(4): 285–96

    Article  PubMed  CAS  Google Scholar 

  82. Siris ES. Bisphosphonates and iritis. Lancet 1993 Feb 13; 341(8842): 436–7

    Article  PubMed  CAS  Google Scholar 

  83. De S, Meyer P, Crisp AJ. Pamidronate and uveitis [letter]. Br J Rheumatol 1995 May; 34(5): 479

    Article  PubMed  CAS  Google Scholar 

  84. Haverbeke G, Pertile G, Claes C, et al. Posterior uveitis: an under-recognized adverse effect of pamidronate: 2 case reports. Bull Soc Belge Ophtalmol 2003; (290): 71–6

    Google Scholar 

  85. Mbekeani JN, Slamovits TL, Schwartz BH, et al. Ocular inflammation associated with alendronate therapy. Arch Ophthalmol 1999 Jun; 117(6): 837–8

    PubMed  CAS  Google Scholar 

  86. ten Doesschate J. Causes of blindness in The Netherlands. Doc Ophthalmol 1982 Jan 29; 52(3-4): 279–85

    Article  PubMed  Google Scholar 

  87. Nussenblatt RB. The natural history of uveitis. Int Ophthalmol 1990 Oct; 14(5-6): 303–8

    Article  PubMed  CAS  Google Scholar 

  88. Krumpaszky HG, Klauss V. Cause of blindness in Bavaria: evaluation of a representative sample from blindness compensation records of Upper Bavaria [in German]. Klin Monatsbl Augenheilkd 1992 Feb; 200(2): 142–6

    Article  PubMed  CAS  Google Scholar 

  89. Durrani OM, Tehrani NN, Marr JE, et al. Degree, duration, and causes of visual loss in uveitis. Br J Ophthalmol 2004 Sep; 88(9): 1159–62

    Article  PubMed  CAS  Google Scholar 

  90. Neri P, Azuara-Blanco A, Forrester JV. Incidence of glaucoma in patients with uveitis. J Glaucoma 2004 Dec; 13(6): 461–5

    Article  PubMed  Google Scholar 

  91. Bodaghi B, Cassoux N, Wechsler B, et al. Chronic severe uveitis: etiology and visual outcome in 927 patients from a single center. Medicine (Baltimore) 2001 Jul; 80(4): 263–70

    Article  CAS  Google Scholar 

  92. Diggory P, Cassels-Brown A, Vail A, et al. Avoiding unsuspected respiratory side-effects of topical timolol with cardioselec-tive or sympathomimetic agents. Lancet 1995 Jun 24; 345(8965): 1604–6

    Article  PubMed  CAS  Google Scholar 

  93. Hooper PL, Rao NA, Smith RE. Cataract extraction in uveitis patients. Surv Ophthalmol 1990 Sep–Oct; 35(2): 120–44

    Article  PubMed  CAS  Google Scholar 

  94. Muccioli C, Belfort Jr R. Cataract surgery in patients with uveitis. Int Ophthalmol Clin 2000 Spring; 40(2): 163–73

    Article  PubMed  CAS  Google Scholar 

  95. Foster CS, Rashid S. Management of coincident cataract and uveitis. Curr Opin Ophthalmol 2003 Feb; 14(1): 1–6

    Article  PubMed  Google Scholar 

  96. Rauz S, Stavrou P, Murray PI. Evaluation of foldable intraocular lenses in patients with uveitis. Ophthalmology 2000 May; 107(5): 909–19

    Article  PubMed  CAS  Google Scholar 

  97. The Royal College of Ophthalmologists. Cataract surgery guidelines 2004 [online]. Available from URL: http://www.rcophth.ac.uk/about/publications/ [Accessed 2006 March 18]

  98. Murray P. Serum autoantibodies and uveitis. Br J Ophthalmol 1986 Apr; 70(4): 266–8

    Article  PubMed  CAS  Google Scholar 

  99. Rahi AH, Tabbara KF. Laboratory investigations in posterior uveitis. Int Ophthalmol Clin 1995 Summer; 35(3): 59–74

    Article  PubMed  CAS  Google Scholar 

  100. Wade NK. Diagnostic testing in patients with ocular inflammation. Int Ophthalmol Clin 2000 Spring; 40(2): 37–54

    Article  PubMed  CAS  Google Scholar 

  101. Heiden D, Nozik RA. A systemic approach to uveitis diagnosis. Ophthalmol Clin North Am 1993; 6: 13–22

    Google Scholar 

  102. Rosenbaum JT, Wernick R. Selection and interpretation of laboratory tests for patients with uveitis. Int Ophthalmol Clin 1990 Fall; 30(4): 238–43

    Article  PubMed  CAS  Google Scholar 

  103. Dick AD, Azim M, Forrester JV. Immunosuppressive therapy for chronic uveitis: optimising therapy with steroids and cyclosporin A. Br J Ophthalmol 1997 Dec; 81(12): 1107–12

    Article  PubMed  CAS  Google Scholar 

  104. Rothova A, Buitenhuis HJ, Meenken C, et al. Uveitis and systemic disease. Br J Ophthalmol 1992 Mar; 76(3): 137–41

    Article  PubMed  CAS  Google Scholar 

  105. Rothova A, Suttorp-van Schulten MS, Frits Treffers W, et al. Causes and frequency of blindness in patients with intraocular inflammatory disease. Br J Ophthalmol 1996 Apr; 80(4): 332–6

    Article  PubMed  CAS  Google Scholar 

  106. Nussenblatt RB, Whitcup SM. Uveitis: fundamentals and clinical practice. 3rd ed. Philadelphia (PA): Mosby, 2004

    Google Scholar 

  107. Weinreb RN, Tessler H. Laboratory diagnosis of ophthalmic sarcoidosis. Surv Ophthalmol 1984 May–Jun; 28(6): 653–64

    Article  PubMed  CAS  Google Scholar 

  108. International Study Group for Behçet’s Disease. Criteria for diagnosis of Behçet’s disease. Lancet 1990 May 5; 335(8697): 1078–80

    Google Scholar 

  109. Levinson RD, Brezin A, Rothova A, et al. Research criteria for the diagnosis of birdshot chorioretinopathy: results of an international consensus conference. Am J Ophthalmol 2006 Jan; 141(1): 185–7

    Article  PubMed  Google Scholar 

  110. Ciardella AP, Prall FR, Borodoker N, et al. Imaging techniques for posterior uveitis. Curr Opin Ophthalmol 2004 Dec; 15(6): 519–30

    Article  PubMed  Google Scholar 

  111. De Laey JJ. Fluorescein angiography in posterior uveitis. Int Ophthalmol Clin 1995 Summer; 35(3): 33–58

    Article  PubMed  Google Scholar 

  112. Tran VT, LeHoang P, Herbort CP. Value of high-frequency ultrasound biomicroscopy in uveitis. Eye 2001 Feb; 15 (Pt 1): 23–30

    Article  PubMed  CAS  Google Scholar 

  113. Antcliff RJ, Stanford MR, Chauhan DS, et al. Comparison between optical coherence tomography and fundus fluorescein angiography for the detection of cystoid macular edema in patients with uveitis. Ophthalmology 2000 Mar; 107(3): 593–9

    Article  PubMed  CAS  Google Scholar 

  114. Cheung CM, Durrani OM, Murray PI. The safety of anterior chamber paracentesis in patients with uveitis. Br J Ophthalmol 2004 Apr; 88(4): 582–3

    Article  PubMed  CAS  Google Scholar 

  115. Lightman S. Uveitis: management. Lancet 1991 Dec 14; 338(8781): 1501–4

    Article  PubMed  CAS  Google Scholar 

  116. Murray PI. Idiopathic (autoimmune) sight threatening uveitis. In: Wormald R, Smeeth L, Henshaw K, editors. Evidence-based ophthalmology. London: BMJ Books, 2004: 167–73

    Google Scholar 

  117. Jabs DA, Rosenbaum JT, Foster CS, et al. Guidelines for the use of immunosuppressive drugs in patients with ocular inflammatory disorders: recommendations of an expert panel. Am J Ophthalmol 2000 Oct; 130(4): 492–513

    Article  PubMed  CAS  Google Scholar 

  118. Riordan-Eva P, Lightman S. Orbital floor steroid injections in the treatment of uveitis. Eye 1994; 8 (Pt 1): 66–9

    Article  PubMed  Google Scholar 

  119. Lafranco Dafflon M, Tran VT, Guex-Crosier Y, et al. Posterior sub-Tenon’s steroid injections for the treatment of posterior ocular inflammation: indications, efficacy and side effects. Graefes Arch Clin Exp Ophthalmol 1999 Apr; 237(4): 289–95

    Article  Google Scholar 

  120. Okada AA, Wakabayashi T, Morimura Y, et al. Trans-Tenon’s retrobulbar triamcinolone infusion for the treatment of uveitis. Br J Ophthalmol 2003 Aug; 87(8): 968–71

    Article  PubMed  CAS  Google Scholar 

  121. Levin DS, Han DP, Dev S, et al. Subtenon’s depot corticosteroid injections in patients with a history of corticosteroid-induced intraocular pressure elevation. Am J Ophthalmol 2002 Feb; 133(2): 196–202

    Article  PubMed  CAS  Google Scholar 

  122. Tehrani NN, Saeed T, Murray PI. Deep intramuscular methyl-prednisolone for the treatment of cystoid macular oedema in uveitis. Eye 2000 Oct; 14 Pt 5: 691–4

    Article  PubMed  Google Scholar 

  123. Degenring RF, Jonas JB. Intravitreal injection of triamcinolone acetonide as treatment for chronic uveitis [letter]. Br J Ophthalmol 2003 Mar; 87(3): 361

    Article  PubMed  CAS  Google Scholar 

  124. Young S, Larkin G, Branley M, et al. Safety and efficacy of intravitreal triamcinolone for cystoid macular oedema in uveitis. Clin Experiment Ophthalmol 2001 Feb; 29(1): 2–6

    Article  PubMed  CAS  Google Scholar 

  125. Kok H, Lau N, et al. Outcome of intravitreal triamcinolone in uveitis. Ophthalmology 2005 Nov; 112(11): 1916–21

    Article  PubMed  Google Scholar 

  126. Jaffe GJ, Martin D, Callanan D, et al. Fluocinolone acetonide implant (Retisert) for noninfectious posterior uveitis: thirty-four-week results of a multicenter randomized clinical study. Ophthalmology 2006 Jun; 113(6): 1020–7

    Article  PubMed  Google Scholar 

  127. The Bone and Tooth Society NOS, Royal College of Physicians. Glucocorticoid-induced osteoporosis: guidelines for prevention and treatment. London: RCP, 2002

    Google Scholar 

  128. Jones NP, Anderton LC, Cheong FM, et al. Corticosteroid-induced osteoporosis in patients with uveitis. Eye 2002 Sep; 16(5): 587–93

    Article  PubMed  CAS  Google Scholar 

  129. Myllykangas-Luosujarvi R, Aho K, Isomaki H. Death attributed to antirheumatic medication in a nationwide series of 1666 patients with rheumatoid arthritis who have died. J Rheumatol 1995 Dec; 22(12): 2214–7

    PubMed  CAS  Google Scholar 

  130. Menezo V, Lau Comer M, et al. Clinical outcome of chronic immunosuppression in patients with non-infectious uveitis. Clin Experiment Ophthalmol 2005 Feb; 33(1): 16–21

    Article  PubMed  Google Scholar 

  131. Smith JR. Management of uveitis. Clin Exp Med 2004 Sep; 4(1): 21–9

    Article  PubMed  CAS  Google Scholar 

  132. Pascalis L, Pia G, Aresu G, et al. Combined cyclosporin A-steroid-MTX treatment in endogenous non-infectious uveitis. J Autoimmun 1993 Aug; 6(4): 467–80

    Article  PubMed  CAS  Google Scholar 

  133. Samson CM, Waheed N, Baltatzis S, et al. Methotrexate therapy for chronic noninfectious uveitis: analysis of a case series of 160 patients. Ophthalmology 2001 Jun; 108(6): 1134–9

    Article  PubMed  CAS  Google Scholar 

  134. Kaplan-Messas A, Barkana Y, Avni I, et al. Methotrexate as a first-line corticosteroid-sparing therapy in a cohort of uveitis and scleritis. Ocul Immunol Inflamm 2003 Jun; 11(2): 131–9

    Article  PubMed  CAS  Google Scholar 

  135. Yazici H, Pazarli H, Barnes CG, et al. A controlled trial of azathioprine in Behçet’s syndrome. N Engl J Med 1990 Feb 1; 322(5): 281–5

    Article  PubMed  CAS  Google Scholar 

  136. Anstey AV, Wakelin S, Reynolds NJ. Guidelines for prescribing azathioprine in dermatology. Br J Dermatol 2004 Dec; 151(6): 1123–32

    Article  PubMed  CAS  Google Scholar 

  137. Kilmartin DJ, Forrester JV, Dick AD. Rescue therapy with mycophenolate mofetil in refractory uveitis. Lancet 1998 Jul 4; 352(9121): 35–6

    Article  PubMed  CAS  Google Scholar 

  138. Siepmann K, Huber M, Stubiger N, et al. Mycophenolate mofetil is a highly effective and safe immunosuppressive agent for the treatment of uveitis: a retrospective analysis of 106 patients. Graefes Arch Clin Exp Ophthalmol 2006; 244(7): 788–94

    Article  PubMed  CAS  Google Scholar 

  139. Zierhut M, Stubiger N, Aboalchamat W, et al. Immunosuppressive therapy with mycophenolate mofetil (CellCept) in treatment of uveitis [in German]. Ophthalmologe 2001 Jul; 98(7): 647–51

    Article  PubMed  CAS  Google Scholar 

  140. Lau CH, Comer M, Lightman S. Long-term efficacy of mycophenolate mofetil in the control of severe intraocular inflammation. Clin Experiment Ophthalmol 2003 Dec; 31(6): 487–91

    Article  PubMed  Google Scholar 

  141. Hesselink DA, Baarsma GS, Kuijpers RW, et al. Experience with cyclosporine in endogenous uveitis posterior. Transplant Proc 2004 Mar; 36 (2 Suppl.): 372S–7S

    Article  PubMed  CAS  Google Scholar 

  142. Lustig MJ, Cunningham Jr ET. Use of immunosuppressive agents in uveitis. Curr Opin Ophthalmol 2003 Dec; 14(6): 399–412

    Article  PubMed  Google Scholar 

  143. Shanmuganathan VA, Casely EM, Raj D, et al. The efficacy of sirolimus in the treatment of patients with refractory uveitis. Br J Ophthalmol 2005 Jun; 89(6): 666–9

    Article  PubMed  CAS  Google Scholar 

  144. Murray PI, Sivaraj RR. Anti-TNF-alpha therapy for uveitis: Behcet and beyond. Eye 2005 Aug; 19(8): 831–3

    Article  PubMed  CAS  Google Scholar 

  145. Akira S, Hirano T, Taga T, et al. Biology of multifunctional cytokines: IL 6 and related molecules (IL 1 and TNF). FASEB J 1990 Aug; 4(11): 2860–7

    PubMed  CAS  Google Scholar 

  146. Mushtaq BST, Situnayake RD, Murray PI. Adalimumab for sight-threatening uveitis in Behçet’s disease. Eye 2006 Apr 7. Epub ahead of print

    Google Scholar 

  147. Becker M, Davis J. Vitrectomy in the treatment of uveitis. Am J Ophthalmol 2005 Dec; 140(6): 1096–105

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

The authors have received no financial support for writing this article and have no conflicts of interest directly relevant to its contents.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Philip I. Murray.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gupta, R., Murray, P.I. Chronic Non-Infectious Uveitis in the Elderly. Drugs Aging 23, 535–558 (2006). https://doi.org/10.2165/00002512-200623070-00001

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00002512-200623070-00001

Keywords

Navigation