New pharmacotherapy options for noninfectious posterior uveitis

Pleyer, Uwe; Neri, Piergiorgio; Deuter, Christoph

doi:10.1007/s10792-021-01763-8

Cited by 21 publications

(9 citation statements)

References 104 publications

(108 reference statements)

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“…In these patients, topical steroids are the major treatment for acute anterior uveitis. Nevertheless, uveitis with posterior or bilateral involvement, or refractory to topical medication, required systemic treatment such as systemic steroids, DMARDs, or biologic agents (45,48). Under these conditions, systemic steroids were the first choice of treatment.…”

Section: Discussionmentioning

confidence: 99%

Increased Risk of Acute Coronary Syndrome in Ankylosing Spondylitis Patients With Uveitis: A Population-Based Cohort Study

et al. 2022

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BackgroundUveitis, a sight-threatening ocular inflammatory state, is associated with autoimmune diseases and systemic inflammation. This prolonged systemic inflammation may cause plaque formation in coronary arteries, subsequently resulting in acute coronary syndrome (ACS).MethodsThis retrospective, population-based study (15-year period) used the Longitudinal Health Insurance Database based on the National Health Insurance Research Database in Taiwan. Chi-square and Student’s t-tests were used to examine differences between the study and comparison cohorts for categorical and continuous variables, respectively. Fine and Gray’s competing risk model was used to determine the hazard ratio of the risk of ACS. Furthermore, the cumulative risk of ACS was determined using Kaplan-Meier analysis.ResultsA total of 1,111 patients with AS and uveitis were enrolled in this study cohort, and 4,444 patients with AS without uveitis were enrolled in the comparison cohort. After adjustment for age, sex, and comorbidities, patients with AS and uveitis demonstrated an increased risk of ACS compared to those without uveitis (adjusted hazard ratio: 1.675, p<0.001). In addition, Kaplan-Meier analysis revealed that patients with AS and uveitis had a significantly higher risk of ACS than those without uveitis (p<0.001). Age, diabetes mellitus, hypertension, hyperlipidemia, chronic obstructive pulmonary disease, asthma, and systemic steroids were significant risk factors for ACS. Both anterior uveitis and posterior segment involvement were associated with an increased risk of ACS in patients with AS. All-cause mortality was higher in the uveitis group (9.81%) than in the non-uveitis group (8.10%) (p=0.015).ConclusionOur analysis revealed that uveitis could potentially be a predictor of ACS in patients with AS. However, further prospective controlled studies are required to assess the association between uveitis and ACS in patients with AS.

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Section: Discussionmentioning

confidence: 99%

Increased Risk of Acute Coronary Syndrome in Ankylosing Spondylitis Patients With Uveitis: A Population-Based Cohort Study

et al. 2022

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“…Although corticosteroids remain to be the mainstay treatments for APU, they may cause signi cant side effects to pediatric patients. Currently, there is no reliable indicator to guide treatment duration [35], and patients are at risk of being treated inadequately or excessively. In our study, multiple linear regression revealed that FAZ, CMT, and DCP VD were factors strongly correlated with CFD.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Macular Capillary Perfusion by Optical Coherence Tomography Angiography on Quiescent Unilateral Anterior Pediatric Uveitis

Xiao¹,

Qu²,

Zhao³

et al. 2021

Preprint

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Purpose: Using spectral domain optical coherence tomography angiography (SD-OCTA) to evaluate tomographic and microvascular parameters in the macula in quiescent unilateral anterior pediatric uveitis (APU) patients.Methods: Forty-two eyes of 21 patients diagnosed with unilateral APU and 21 eyes of 21 normal controls (NC) were included in this study. 6*6 mm macular scanning mode of SD-OCTA was used for all subjects. The central macular thickness (CMT), subfoveal choroidal thickness (SFCT), vascular density (VD) of superficial capillary plexus (SCP) and the deep capillary plexus (DCP), the foveal avascular zone (FAZ) area, and choriocapillary flow density (CFD) were analyzed and compared among affected, fellow, and NC eyes. Correlation analysis were used to evaluate the potential correlating factors with CFD.Results: DCP VD and CFD were significantly lower in quiescent affected eyes as compared to fellow and NCs eyes (DCP VD both p<0.001; CDF1.0: p=0.012 and p=0.003; CDF1.5: p=0.015 and p=0.006; CDF3.0: p=0.036 and p=0.010, respectively). SCP VD, DCP VD and CMT were significantly lower in the fellow eyes as compared to NC eyes (p=0.021; p<0.001; p=0.037, respectively); CFD was negatively correlated with FAZ and CMT in affected eyes and fellow eyes. No significant differences were detected in FAZ among the 3 groups (p > .05).Conclusions: As compared to NC eyes, both retinal and choroidal microvasculature were impaired in eyes with quiescent APU; retinal microvasculature in unaffected fellow eyes of unilateral APU was also impaired. OCTA is a useful technology for detection of subclinical microvascular changes in APU and may be useful as an additional prognostic tool.

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“…Robust, conventional immune responses, for instance in the lung, the gut or the skin, have a good chance of clearing the infection and restoring tissue homeostasis in an otherwise healthy individual. In contrast, the attenuated immunity of IP does not seem to be very effective either in clearing the infection or preventing intraocular inflammation (IOI) [uveitis is a significant cause of blindness, www.who.int/blindness (28)]. Moreover, IP has not been demonstrated convincingly for infectious foreign antigens [reviewed in (5)].…”

Section: Immune Privilege Is One Form Of Immunological Tolerancementioning

confidence: 99%

Immune Privilege Furnishes a Niche for Latent Infection

2022

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The microenvironment of the CNS (eye and brain) is fertile ground for infection if the barriers are breached. The result of pathogen invasion is often devastating destruction of tissues. In the eye, inflammation is broadly classified either as “infectious” (i.e. caused by infection) or “non-infectious”. However, increasingly, forms of intraocular inflammation (IOI), which clinically appear to be “non-infectious” turn out to be initiated by infectious agents, suggesting that pathogens have been retained in latent or persistent form within ocular tissues and have reactivated to cause overt disease. A similar pathogenesis applies to latent infections in the brain. Not all CNS tissues provide an equally protective niche while different pathogens escape detection using different strategies. This review summarises how immune privilege (IP) in the CNS may be permissive for latent infection and allow the eye and the brain to act as a reservoir of pathogens which often remain undetected for the lifetime of the host but in states of immune deficiency may be activated to cause sight- and life-threatening inflammation.

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New pharmacotherapy options for noninfectious posterior uveitis

Cited by 21 publications

References 104 publications

Increased Risk of Acute Coronary Syndrome in Ankylosing Spondylitis Patients With Uveitis: A Population-Based Cohort Study

Increased Risk of Acute Coronary Syndrome in Ankylosing Spondylitis Patients With Uveitis: A Population-Based Cohort Study

Assessment of Macular Capillary Perfusion by Optical Coherence Tomography Angiography on Quiescent Unilateral Anterior Pediatric Uveitis

Immune Privilege Furnishes a Niche for Latent Infection

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