Introduction:
Non-infectious uveitis encompasses a group of inflammatory eye diseases that can cause irreversible vision loss if left untreated or undertreated. In cases requiring stemic treatment, a step-wise treatment approach is often employed starting with corticosteroids for severe active disease, followed by initiation of steroid-sparing therapies to maintain inflammatory control and avoid the abundant complications of long-term corticosteroid use.
Areas covered:
We review the current high-quality evidence comparing the efficacy of various systemic steroid-sparing agents in the treatment of non-infectious uveitis. For studies to be included, they had to have a prospective, randomized, comparative design or a retrospective design including at least 100 patients.
Expert commentary:
Given the rarity of uveitis and the heterogeneity of uveitic diseases, there are few randomized controlled studies that directly compare the relative efficacy of the various steroid-sparing immunosuppressive agents. Therefore, current treatment strategies are based mainly on data from observational series.
Uveitis encompasses a spectrum of diseases whose common feature is intraocular inflammation, which may be infectious or noninfectious in etiology (Nussenblatt and Whitcup 2010). Infectious causes of uveitis are typically treated with appropriate antimicrobial therapy and will not be discussed in this chapter. Noninfectious uveitides are thought have an autoimmune component to their etiology and are thus treated with anti-inflammatory agents.
Masquerade syndromes present to uveitis clinics due to the appearance of inflammatory signs and chronic symptoms that are not responsive to conventional treatment. They are frequently misdiagnosed and treated as refractory inflammatory conditions, which delays appropriate diagnosis and management. This review of literature focuses on the commonly encountered masquerade syndromes and discusses the role of multimodal imaging in addressing these complex clinical presentations. We review the conventional imaging techniques for these patients and discuss emerging technological advances that may help in establishing a diagnosis. We present cases highlighting the utility of multimodal imaging in identifying the etiology.
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