Therapeutic options for the treatment of non-infectious uveitis

Corticosteroids and Anti-Complement Therapy in Retinal Diseases

“…Liver biopsy is warranted if enzyme abnormalities continue despite discontinuation of the drug. Treatment should be terminated if the following conditions occur: WBC <2,500 μl, platelet count <75,000/μl, or liver enzymes !5 times the upper limit of normal (Knickelbein et al 2015).…”

“…These agents decrease inflammation by interfering with signaling pathways involved in the function and proliferation of T cells (Knickelbein et al 2015). Special considerations include addition of folic acid to the regimen for methotrexate and prophylactic use of Bactrim (to minimize the risk of infection with neutropenia), considering the use of Mesna (to avoid bladder toxicity) and counseling for fertility preservation for patients who plan on starting cyclophosphamide…”

“…Adult patients are treated with 3-5 mg/kg by mouth, divided into twice daily equal doses (Knickelbein et al 2015). The dose should be decreased if blood pressure or creatinine levels rise, and treatment should be discontinued if values fail to normalize following dose adjustment.…”

“…Concomitant administration of folic acid can mitigate these effects at the recommended dose of 1 mg by mouth daily, excluding the day that methotrexate is taken (Knickelbein et al 2015). Patients should also be advised to abstain from alcohol use during treatment.…”

“…In adults, systemic methotrexate is typically started at 2.5-10 mg/week, which is then increased to an average of 15 mg/week (ranging from 7.5 to 25 mg) after several weeks if well tolerated (Jabs et al 2000;Knickelbein et al 2015). Intravitreal injections are dosed at 400 μg in 0.1 mL (Taylor et al 2013).…”