New observations and emerging ideas in diagnosis and management of non-infectious uveitis: A review

James (Jim) Rosenbaum, Bahram Bodaghi, Cristobal Couto, Manfred Zierhut, Nisha Acharya, Carlos Pavesio, Mei Ling Tay-Kearney, Piergiorgio Neri, Kevin Douglas, Sophia Pathai, Alexandra P. Song, Martina Kron, C. Stephen Foster

Research output: Contribution to journalReview article

3 Citations (Scopus)

Abstract

Background: Non-infectious uveitis (NIU) is an immune-mediated disease with clinical symptoms such as eye pain, redness, floaters, and light sensitivity. NIU is one of the leading causes of preventable blindness. Objective: This review describes current and emerging therapies for NIU. Methods: PubMed searches were conducted using the terms uveitis, therapy, corticosteroids, immunomodulators, biologics, intravitreal injections, intraocular implants, and adverse events deemed relevant if they presented data relating to prevalence, diagnosis, and treatment of uveitis. Results: Diagnosis and management of NIU may require collaboration among different healthcare providers, including ophthalmologists and rheumatologists. Although many patients with NIU respond to corticosteroid (CS) therapy, long-term CS use can be associated with potentially severe adverse events. Localized CS therapies have been developed to reduce adverse events; however, some intravitreal injections and intraocular implants were linked to elevated intraocular pressure and cataracts. CS-sparing therapies such as biologics have demonstrated efficacy and safety while reducing CS burden. Biologics targeting tumor necrosis factor provide CS-sparing options for patients with NIU. Additional studies are needed to address long-term efficacy and safety of biologics targeting IL-6 and inhibitors of JAK/STAT. Conclusion: Biologics, JAK/STAT inhibitors, and improved localized therapies may provide additional options for patients with NIU.

Original languageEnglish (US)
JournalSeminars in Arthritis and Rheumatism
DOIs
StatePublished - Jan 1 2019

Fingerprint

Uveitis
Adrenal Cortex Hormones
Biological Products
Intravitreal Injections
Therapeutics
Eye Pain
Safety
Photophobia
Immune System Diseases
Immunologic Factors
Blindness
Intraocular Pressure
PubMed
Health Personnel
Cataract
Interleukin-6
Tumor Necrosis Factor-alpha

Keywords

  • Adalimumab
  • Biologics
  • Corticosteroid-sparing therapy
  • Immune-mediated disease
  • Noninfectious uveitis

ASJC Scopus subject areas

  • Rheumatology
  • Anesthesiology and Pain Medicine

Cite this

New observations and emerging ideas in diagnosis and management of non-infectious uveitis : A review. / Rosenbaum, James (Jim); Bodaghi, Bahram; Couto, Cristobal; Zierhut, Manfred; Acharya, Nisha; Pavesio, Carlos; Tay-Kearney, Mei Ling; Neri, Piergiorgio; Douglas, Kevin; Pathai, Sophia; Song, Alexandra P.; Kron, Martina; Foster, C. Stephen.

In: Seminars in Arthritis and Rheumatism, 01.01.2019.

Research output: Contribution to journalReview article

Rosenbaum, JJ, Bodaghi, B, Couto, C, Zierhut, M, Acharya, N, Pavesio, C, Tay-Kearney, ML, Neri, P, Douglas, K, Pathai, S, Song, AP, Kron, M & Foster, CS 2019, 'New observations and emerging ideas in diagnosis and management of non-infectious uveitis: A review', Seminars in Arthritis and Rheumatism. https://doi.org/10.1016/j.semarthrit.2019.06.004
Rosenbaum, James (Jim) ; Bodaghi, Bahram ; Couto, Cristobal ; Zierhut, Manfred ; Acharya, Nisha ; Pavesio, Carlos ; Tay-Kearney, Mei Ling ; Neri, Piergiorgio ; Douglas, Kevin ; Pathai, Sophia ; Song, Alexandra P. ; Kron, Martina ; Foster, C. Stephen. / New observations and emerging ideas in diagnosis and management of non-infectious uveitis : A review. In: Seminars in Arthritis and Rheumatism. 2019.
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AU - Bodaghi, Bahram

AU - Couto, Cristobal

AU - Zierhut, Manfred

AU - Acharya, Nisha

AU - Pavesio, Carlos

AU - Tay-Kearney, Mei Ling

AU - Neri, Piergiorgio

AU - Douglas, Kevin

AU - Pathai, Sophia

AU - Song, Alexandra P.

AU - Kron, Martina

AU - Foster, C. Stephen

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AB - Background: Non-infectious uveitis (NIU) is an immune-mediated disease with clinical symptoms such as eye pain, redness, floaters, and light sensitivity. NIU is one of the leading causes of preventable blindness. Objective: This review describes current and emerging therapies for NIU. Methods: PubMed searches were conducted using the terms uveitis, therapy, corticosteroids, immunomodulators, biologics, intravitreal injections, intraocular implants, and adverse events deemed relevant if they presented data relating to prevalence, diagnosis, and treatment of uveitis. Results: Diagnosis and management of NIU may require collaboration among different healthcare providers, including ophthalmologists and rheumatologists. Although many patients with NIU respond to corticosteroid (CS) therapy, long-term CS use can be associated with potentially severe adverse events. Localized CS therapies have been developed to reduce adverse events; however, some intravitreal injections and intraocular implants were linked to elevated intraocular pressure and cataracts. CS-sparing therapies such as biologics have demonstrated efficacy and safety while reducing CS burden. Biologics targeting tumor necrosis factor provide CS-sparing options for patients with NIU. Additional studies are needed to address long-term efficacy and safety of biologics targeting IL-6 and inhibitors of JAK/STAT. Conclusion: Biologics, JAK/STAT inhibitors, and improved localized therapies may provide additional options for patients with NIU.

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