Skip to main content
SpringerLink
Log in

Systemic Corticosteroids in the Treatment of Uveitis

  • Chapter
  • First Online:
Treatment of Non-infectious Uveitis

  • 429 Accesses

Abstract

Corticosteroids are still the mainstay in the treatment of uveitis due to their potent anti-inflammatory and immunosuppressant mechanisms. Various forms and routes of administration exist, each with its own positive and negative attributes. Due to the diverse function of gluco- and mineralocorticoids in the body, synthetic corticosteroids always come with adverse effects. Treating physicians must be aware of all the potential effects of these medications and provide adequate counseling and monitoring when treating their patients.

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

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Gordon DM. Prednisone and prednisolone in ocular disease. Am J Ophthalmol. 1956;41(4):593–600.

    Article  CAS  Google Scholar 

  2. Coutinho AE, Chapman KE. The anti-inflammatory and immunosuppressive effects of glucocorticoids, recent developments and mechanistic insights. Mol Cell Endocrinol. 2011;335(1):2–13. https://doi.org/10.1016/j.mce.2010.04.005.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Smoak KA, Cidlowski JA. Mechanisms of glucocorticoid receptor signaling during inflammation. Mech Ageing Dev. 2004;125:697–706.

    Article  CAS  Google Scholar 

  4. Newton R, Holden NS. Separating transrepression and transactivation: a distressing divorce for the glucocorticoid receptor? Mol Pharmacol. 2007;72:799–809.

    Article  CAS  Google Scholar 

  5. Matyszak MK, Citterio S, Rescigno M, et al. Differential effects of corticosteroids during different stages of dendritic cell maturation. Eur J Immunol. 2000;30:1233–42.

    Article  CAS  Google Scholar 

  6. Newton R, Seybold J, Kuitert LME, Bergmann M, Barnes PJ. Repression of cyclooxygenase-2 and prostaglandin E2 release by dexamethasone occurs by transcriptional and post-transcriptional mechanisms involving loss of polyadenylated mRNA. J Biol Chem. 1998;273:32312–21.

    Article  CAS  Google Scholar 

  7. Liu D, Ahmet A, Ward L, et al. A practical guide to the monitoring and management of the complications of systemic corticosteroid therapy. Allergy Asthma Clin Immunol. 2013;9(1):30. https://doi.org/10.1186/1710-1492-9-30.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Babu K, Mahendradas P. Medical management of uveitis – current trends. Indian J Ophthalmol. 2013;61(6):277–83. https://doi.org/10.4103/0301-4738.114099.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Movahedi M, Costello R, Lunt M, Pye SR, Sergeant JC, Dixon WG. Oral glucocorticoid therapy and all-cause and cause-specific mortality in patients with rheumatoid arthritis: a retrospective cohort study. Eur J Epidemiol. 2016;31(10):1045–55. https://doi.org/10.1007/s10654-016-0167-1.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Wasko MC, Dasgupta A, Sears GI, Fries JF, Ward MM. Prednisone use and risk of mortality in patients with rheumatoid arthritis: Moderation by use of disease-modifying anti-rheumatic drugs. Arthritis Care Res. 2016;68(5):706–10. https://doi.org/10.1002/acr.22722.

    Article  CAS  Google Scholar 

  11. Lewis JD, Scott FI, Brensinger CM, et al. Increased mortality rates with prolonged corticosteroid therapy when compared with antitumor necrosis factor-α-directed therapy for inflammatory bowel disease. Am J Gastroenterol. 2018;113(3):405–17. https://doi.org/10.1038/ajg.2017.479.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Waljee AK, Rogers MA, Lin P, Singal AG, Stein JD, Marks RM, Ayanian JZ, Nallamothu BK. Short term use of oral corticosteroids and related harms among adults in the United States: population based cohort study. BMJ. 2017;357:j1415. https://doi.org/10.1136/bmj.j1415.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Dekkers OM, Horvath-Puho E, Jorgensen JO, Cannegieter SC, Ehrenstein V, Vandenbroucke JP, Pereira AM, Sorensen HT. Multi-system morbidity and mortality in Cushing’s syndrome: a cohort study. J Clin Endocrinol Metab. 2013;98:2277–84.

    Article  CAS  Google Scholar 

  14. Coelho MC, Santos CV, Vieira Neto L, Gadelha MR. Adverse effects of glucocorticoids: coagulopathy. Eur J Endocrinol. 2015;173:M11–21.

    Article  CAS  Google Scholar 

  15. Kok C, Sambrook PN. Secondary osteoporosis in patients with an osteoporotic fracture. Best Pract Res Clin Rheumatol. 2009;23:769–79.

    Article  CAS  Google Scholar 

  16. Briot K, Roux C. Glucocorticoid-induced osteoporosis. RMD Open. 2015;1:e000014. https://doi.org/10.1136/rmdopen-2014-000014.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Grossman JM, Gordon R, Ranganath VK, Deal C, Caplan L, Chen W, Curtis JR, Furst DE, McMahaon M, Parker NM, Volkmann E, Saag KG. American College of Rhematology 2010 recommendations for the prevention and treatment of glucocorticoid-induced osteoporosis. Arthritis Care Res. 2010;62(11):1515–26.

    Article  Google Scholar 

  18. Tamez-Pérez HE, Quintanilla-Flores DL, Rodríguez-Gutiérrez R, González-González JG, Tamez-Peña AL. Steroid hyperglycemia: prevalence, early detection and therapeutic recommendations: a narrative review. World J Diabetes. 2015;6(8):1073–81. https://doi.org/10.4239/wjd.v6.i8.1073.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Gulliford MC, Charlton J, Latinovic R. Risk of diabetes associated with prescribed glucocorticoids in a large population. Diabetes Care. 2006;29:2728–9.

    Article  CAS  Google Scholar 

  20. Perez A, Jansen-Chaparro S, Saigi I, Bernal-Lopez MR, Miñambres I, Gomez-Huelgas R. Glucocorticoid-induced hyperglycemia. J Diabetes. 2014;6:9–20.

    Article  CAS  Google Scholar 

  21. Ruzzin J, Wagman AS, Jensen J. Glucocorticoid-induced insulin resistance in skeletal muscles: defects in insulin signalling and the effects of a selective glycogen synthase kinase-3 inhibitor. Diabetologia. 2005;48:2119–30.

    Article  CAS  Google Scholar 

  22. Trence DL. Management of patients on chronic glucocorticoid therapy: an endocrine perspective. Prim Care. 2003;30:593–605.

    Article  Google Scholar 

  23. Hirsch IB, Paauw DS. Diabetes management in special situations. Endocrinol Metab Clin N Am. 1997;26:631–45.

    Article  CAS  Google Scholar 

  24. Nieman LK. Cushing’s syndrome: update on signs, symptoms and biochemical screening. Eur J Endocrinol. 2015;173:M33–8.

    Article  CAS  Google Scholar 

  25. Drozdowicz LB, Bostwick JM. Psychiatric adverse effects of pediatric corticosteroid use. Mayo Clin Proc. 2014;89(6):817–34.

    Article  CAS  Google Scholar 

  26. Geer EB, Islam J, Buettner C. Mechanisms of glucocorticoid-induced insulin resistance: focus on adipose tissue function and lipid metabolism. Endocrinol Metab Clin N Am. 2014;43(1):75–102.

    Article  CAS  Google Scholar 

  27. Etxabe J, Vazquez JA. Morbidity and mortality in Cushing’s disease: an epidemiological approach. Clin Endocrinol. 1994;40(4):479–84.

    Article  CAS  Google Scholar 

  28. Youssef J, Novosad SA, Winthrop KL. Infection risk and safety of corticosteroid use. Rheum Dis Clin N Am. 2016;42(1):157–76.

    Article  Google Scholar 

  29. Ferrau F, Korbonits M. Metabolic comorbidities in Cushing’s syndrome. Eur J Endocrinol. 2015;173(4):M133–57.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Uveitis and Ocular Immunology, Retinal Consultants Inc., Sacramento, CA, USA

    Sarju S. Patel

  2. New York Medical College - MS3, Valhalla, NY, USA

    Abhiniti Mittal

Authors
  1. Sarju S. Patel
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Abhiniti Mittal
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Oregon Health and Science University, Casey Eye Institute, Portland, OR, USA

    Phoebe Lin

  2. Oregon Health and Science University, OHSU-PSU School of Public Health, Portland Veterans Administration Medical Center, Portland, OR, USA

    Eric Suhler

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Patel, S.S., Mittal, A. (2019). Systemic Corticosteroids in the Treatment of Uveitis. In: Lin, P., Suhler, E. (eds) Treatment of Non-infectious Uveitis. Springer, Cham. https://doi.org/10.1007/978-3-030-22827-9_3

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-22827-9_3

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-22825-5

  • Online ISBN: 978-3-030-22827-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation