The prevalence of sight-threatening uveitis in Scotland

Williams, G.; Brannan, S; Forrester, John V.; Gavin, M; Paterson-Brown, Sheila P; Purdie, Alasdair; Virdi, Meena; Olson, John A.

doi:10.1136/bjo.2006.101386

Cited by 40 publications

(22 citation statements)

References 12 publications

(6 reference statements)

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“…The concomitant developments in genetic profiling and pharmacogenetics will assist in developing prognostic indicators of disease outcome as well as response to drugs. For example, just under a quarter of people with intraocular inflammation will require immunosuppression [156], for which corticosteroids remain the first-line treatment [157], and are likely to be so for the next 5 years. However, efficacy is limited by their side effects and it is estimated that a third of patients are unable to achieve disease control at tolerable systemic doses [158].…”

Section: Tailored Therapies: Improved Diagnosticsmentioning

confidence: 99%

Immune mechanisms of intraocular inflammation

Schewitz-Bowers¹,

Lee

Dick³

2010

Expert Review of Ophthalmology

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Section: Tailored Therapies: Improved Diagnosticsmentioning

confidence: 99%

Immune mechanisms of intraocular inflammation

Schewitz-Bowers¹,

Lee

Dick³

2010

Expert Review of Ophthalmology

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“…Uveitis is a common disease (Darrell et al, 1962; Gritz and Wong, 2004; Williams et al, 2007) and comes in several varieties ( Box 1 ). Direct infectious uveitis is less common while non-infectious uveitis is presumed to be (auto)immune in character.…”

Section: Breaches Of Privilegementioning

confidence: 99%

Good news–bad news: the Yin and Yang of immune privilege in the eye

Forrester¹,

Xu²

2012

Front. Immun.

120

111

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The eye and the brain are prototypical tissues manifesting immune privilege (IP) in which immune responses to foreign antigens, particularly alloantigens are suppressed, and even completely inhibited. Explanations for this phenomenon are numerous and mostly reflect our evolving understanding of the molecular and cellular processes underpinning immunological responses generally. IP is now viewed as a property of many tissues and the level of expression of IP varies not only with the tissue but with the nature of the foreign antigen and changes in the limited conditions under which privilege can operate as a mechanism of immunological tolerance. As a result, IP functions normally as a homeostatic mechanism preserving normal function in tissues, particularly those with highly specialized function and limited capacity for renewal such as the eye and brain. However, IP is relatively easily bypassed in the face of a sufficiently strong immunological response, and the privileged tissues may be at greater risk of collateral damage because its natural defenses are more easily breached than in a fully immunocompetent tissue which rapidly rejects foreign antigen and restores integrity. This two-edged sword cuts its swathe through the eye: under most circumstances, IP mechanisms such as blood–ocular barriers, intraocular immune modulators, induction of T regulatory cells, lack of lymphatics, and other properties maintain tissue integrity; however, when these are breached, various degrees of tissue damage occur from severe tissue destruction in retinal viral infections and other forms of uveoretinal inflammation, to less severe inflammatory responses in conditions such as macular degeneration. Conversely, ocular IP and tumor-related IP can combine to permit extensive tumor growth and increased risk of metastasis thus threatening the survival of the host.

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“…Uveitis describes a group of disorders characterised by intraocular inflammation. Uveitis is the fifth commonest cause of visual loss in the developed world and accounts for about 10–15 % of total blindness [ 1 , 2 ] and up to 25 % in the developing world [ 3 , 4 ]. Although uveitis may affect any age group, it peaks in the working age population with no significant gender difference [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…Although uveitis may affect any age group, it peaks in the working age population with no significant gender difference [ 5 ]. The annual incidence of uveitis is estimated at 14–50 per 100,000 with a prevalence of around 38–200 per 100,000 general population [ 1 , 2 , 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

The effectiveness of pharmacological agents for the treatment of uveitic macular oedema (UMO): a systematic review protocol

et al. 2016

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BackgroundMacular oedema (MO) describes the accumulation of fluid in the central part of the retina, known as the ‘macula’ which provides central vision. MO is the leading cause of sight loss in patients with intraocular inflammation (uveitis). There is a lack of consensus over the treatment of uveitic macular oedema (UMO). The proposed systematic review will evaluate the evidence on the effectiveness of pharmacological agents used to treat UMO. All systemic, local, or topical pharmacological agents will be included.Method/designStandard systematic review methodology will be employed to identify, select and extract data from comparative studies (randomised/non-randomised trials and observational studies) of the pharmacological interventions in patients with UMO. Searches will be conducted through bibliographic databases (Cochrane Library, MEDLINE, EMBASE and CINAHL) and clinical trials registers. No restriction will be placed on either language or year of publication. Translation of non-English language articles will be undertaken to minimise selection bias. The primary outcome of interest will be best corrected visual acuity and secondary outcomes will be adverse events, health-related quality of life, assessment of UMO using central macular thickness (e.g. by optical coherence topography (OCT)), clinical and angiographic assessment of UMO, clinical estimation of vitreous haze. Risk of bias assessment appropriate to each study design will be undertaken. Data will be grouped by comparison, tabulated and narratively synthesised. Meta-analysis will be undertaken where clinical and methodological homogeneity exists. Subgroup and sensitivity analyses, also network analyses and intra/inter-pharmacological class analyses will be undertaken where deemed appropriate.DiscussionA number of published studies have investigated the effectiveness of the pharmacological agents used to treat UMO. However, there is no recent systematic review that synthesises this evidence. This systematic review will analyse the effectiveness of systemic, local and topical therapies to treat UMO. The findings will provide important evidence to inform clinical and health policy decision-making for the treatment of UMO.Systematic review registrationProspero CRD42015019170Electronic supplementary materialThe online version of this article (doi:10.1186/s13643-016-0203-y) contains supplementary material, which is available to authorized users.

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The prevalence of sight-threatening uveitis in Scotland

Cited by 40 publications

References 12 publications

Immune mechanisms of intraocular inflammation

Immune mechanisms of intraocular inflammation

Good news–bad news: the Yin and Yang of immune privilege in the eye

The effectiveness of pharmacological agents for the treatment of uveitic macular oedema (UMO): a systematic review protocol

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