Treatment Strategies in Patients With Posterior Uveitis

Na, Sabrosa; Pavesio, Carolos E

doi:10.1097/00004397-200004000-00012

Cited by 6 publications

(15 citation statements)

References 22 publications

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“…Oral or intravitreal corticosteroids are therefore used to treat cases of posterior segment disease. Oral prednisone (1 mg/kg/day with gradual tapering) is often the first therapeutic agent used [4]. …”

Section: Initial Treatment: Corticosteroidsmentioning

confidence: 99%

Systemic Treatments for Noninfectious Vitreous Inflammation

Jiang

Wang

Joshi

et al. 2013

Mediators of Inflammation

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Vitreous inflammation, or vitritis, may result from many causes, including both infectious and noninfectious, including rheumatologic and autoimmune processes. Vitritis is commonly vision threatening and has serious sequelae. Treatment is frequently challenging, but, today, there are multiple methods of systemic treatment for vitritis. These categories include corticosteroids, antimetabolites, alkylating agents, T-cell inhibitors/calcineurin inhibitors, and biologic agents. These treatment categories were reviewed last year, but, even over the course of just a year, many therapies have made progress, as we have learned more about their indications and efficacy. We discuss here discoveries made over the past year on both existing and new drugs, as well as reviewing mechanisms of action, clinical dosages, specific conditions that are treated, adverse effects, and usual course of treatment for each class of therapy.

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Section: Initial Treatment: Corticosteroidsmentioning

confidence: 99%

Systemic Treatments for Noninfectious Vitreous Inflammation

Jiang

Wang

Joshi

et al. 2013

Mediators of Inflammation

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“…Inflammation of the retina and choroid results in decreased visual acuity and distorted vision with associated scotomata and floaters (Opremcak et al 2004). This form of uveitis accounts for more visual loss than other forms, often due to cystoid macular edema, retinal detachment, cataract, glaucoma, subretinal fibrosis, and optic disc atrophy (Sabrosa and Pavésio 2000). Posterior uveitis is often infectious, with toxoplasmosis representing 24.6% of cases and cytomegalovirus, 11.6%.…”

Section: Uveitis: a Challenging Condition To Diagnose And Managementioning

confidence: 99%

“…Local injection of long-acting steroids such as methylprednisolone or triamcinolone, however, results in therapeutic concentrations in the posterior segment and therefore can be useful for treatment of posterior uveitis in some individuals (Sabrosa and Pavésio 2000). The relatively low systemic concentration of steroids achieved by this method spares patients from the usual complications of steroid therapy, such as Cushingoid features, bone marrow suppression and infection, avascular necrosis, hyperglycemia, and osteopenia (Sabrosa and Pavésio 2000).…”

Section: Uveitis: a Challenging Condition To Diagnose And Managementioning

confidence: 99%

“…The relatively low systemic concentration of steroids achieved by this method spares patients from the usual complications of steroid therapy, such as Cushingoid features, bone marrow suppression and infection, avascular necrosis, hyperglycemia, and osteopenia (Sabrosa and Pavésio 2000). Disadvantages to this form of therapy, however, include the necessity of repeated local injections as the steroid concentration in the posterior segment declines and the recurrence of inflammation every 2–3 months (Jabs et al 2005).…”

Section: Uveitis: a Challenging Condition To Diagnose And Managementioning

confidence: 99%

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Fluocinolone acetonide intravitreal sustained release device ? a new addition to the armamentarium of uveitic management

Brumm¹,

Nguyen²

2007

International Journal of Nanomedicine

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Uveitis is a potentially sight-threatening infl ammatory eye disease caused by multiple infectious and non-infectious etiologies for which the standard of care involves corticosteroids or various immunomodulary therapy (IMT) drugs. These available treatments, although effective, may cause signifi cant morbidity and sometimes mortality in uveitis patients due to their toxic side-effects and the necessity of long-term therapy to prevent recurrences. In order to avoid the systemic toxicity of corticosteroids and IMT or the repeated injections of local steroids necessary to control ocular infl ammation, and to prevent development of cumulative damage resulting from recurrent episodes of infl ammation, researchers have developed a number of local corticosteroid sustained-release devices that can be implanted directly into the vitreous of the eye, at the site of the infl ammatory disease. Preliminary studies of such a device, the fl uocinolone acetonide (Retisert™) implant, have shown signifi cant reductions in the number of infl ammatory episodes and decreased reliance on systemic corticosteroids or other IMT. This review explores the current research evaluating the fl uocinolone sustained-release intravitreal implant in the treatment of posterior uveitis and the implications for its future use on a wider scale.

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“…Moreover, high acute intraocular drug concentrations may induce severe local toxicity and increase the intraocular pressure. 13,14 Glucocorticoid side effects associated with high effective dose levels and dosing frequencies can be reduced by incorporating the drugs in (PEGylated) liposomes. We have developed a clinical-stage innovative drug delivery technology, called the G-Technology, which enlarges the therapeutic window of the glucocorticoid drug methylprednisolone.…”

mentioning

confidence: 99%