Guidelines for the use of immunosuppressive drugs in patients with ocular inflammatory disorders: recommendations of an expert panel

Jabs, Douglas A.; Rosenbaum, James T.; Foster, C. Stephen; Holland, Gary N.; Jaffe, Glenn J.; Louie, James S.; Nussenblatt, Robert B.; Stiehm, E. Richard; Tessler, Howard H.; Gelder, Russell N. Van; Whitcup, Scott M.; Yocum, David E.

doi:10.1016/s0002-9394(00)00659-0

Cited by 869 publications

(537 citation statements)

References 101 publications

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“…Orally administered prednisolone is the commonest form of systemic immunosuppression used in uveitis [120]. An initial high dose of 60–80 mg/day (1 mg/kg body weight) is tapered gradually with the aim of either stopping the prednisolone or reducing the dose below 10 mg/day.…”

Section: Treatment Optionsmentioning

confidence: 99%

Uveitis: A Potentially Blinding Disease

Durrani¹,

Meads

Murray³

2004

Ophthalmologica

262

170

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Uveitis (intraocular inflammation) is a potentially blinding group of, probably autoimmune, conditions predominantly occurring in the working age group. Although the aetiology is unknown in most cases, many patients have an associated underlying systemic disease. Central vision loss, in the form of cystoid macular oedema, is the commonest type of visual impairment. Although historical incidence and prevalence data exists, little is known about the degree of vision loss experienced, and the social and financial consequences of having temporary or permanent visual impairment in this age group. The literature is also full of uncontrolled studies and case reports of different modalities of drug therapy for uveitis. This article attempts to raise the awareness of uveitis as an important sight-threatening group of conditions by highlighting the paucity of evidence-based data on epidemiological, quality of life, socioeconomic, and therapeutic aspects.

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Section: Treatment Optionsmentioning

confidence: 99%

Uveitis: A Potentially Blinding Disease

Durrani¹,

Meads

Murray³

2004

Ophthalmologica

262

170

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“…Given that prolonged use of corticosteroids, such as prednisolone, at doses over 10 mg may cause side effects such as mood issues and blurred vision (Jabs et al, 2000) it is perhaps not surprising that in the present study patients taking 10 mg or more corticosteroid daily had significantly lower PMI scores than those on a lower dose or not taking corticosteroid medication. The mean (+ SD) PMI score for the 32 patients taking 10 mg or more was 2.91 + 0.69, which is slightly below the proposed norm for the PMI.…”

Section: Discussionmentioning

confidence: 53%

“…There is no known cure; corticosteroids, such as prednisolone, are often used to control the symptoms, but prolonged use at higher doses (> 10 mg) may cause side effects (Jabs et al, 2000).…”

Section: Introductionmentioning

confidence: 99%

Validation of a Brief Questionnaire Measuring Positive Mindset in Patients With Uveitis

Barry¹,

Folkard²,

Ayliffe³

2014

Psychol. Community Health

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Aim: Illness may impact the positivity of a person's mindset. However, patients with visual impairment, such as uveitis, may struggle to complete questionnaires. The aim of this study was to validate a brief and simple measure of positive mindset in people with uveitis. Method: This study was a cross-sectional survey of 200 people with uveitis. The Positive Mindset Index (PMI) questionnaire uses six items to measure a patient's happiness, confidence, sense of being in control, stability, motivation, and optimism. Results: Exploratory factor analysis revealed a well-fitting unidimensional factor structure (KMO = .898), with strong factor loadings (from .616 to .721) and excellent internal reliability (Cronbach's α = .926). The PMI showed strong concurrent validity with the mental health subscale of the SF-36 (r = .789) and good construct validity relative to the physical health subscale of the SF-36 (r = .468). Excellent test-retest reliability was seen (r = .806). Patients taking 10 mg or more corticosteroid daily had significantly lower PMI scores than those on a lower dose or no dose (t (170) = 2.298, p < .023). Conclusion:The PMI has good face validity and sound psychometric properties. It is a very brief and simple measure, thus user-friendly for patients with visual impairment, as well as researchers and others using the scale.

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“…2,3 Conventional management begins with adjuvant therapies, such as lubrication; topical and systemic steroid therapy; and, in severe cases, immunomodulatory therapy like azathioprine, cyclophosphamide, cyclosporine, and systemic immunoglobulin. [4][5][6] Occasionally, the conventional immunomodulatory therapy applied is inefficient in the control of ocular inflammation. Moreover, systemic side effects and toxicity are responsible for the discontinuity of the treatment.…”

Section: Introductionmentioning

confidence: 99%