Klin Farmakol Farm. 2009;23(3):115-119

Therapy of uveitis

doc. MUDr. Petra Svozílková, Ph.D, Eva Říhová, Jarmila Heissigerová, Michaela Brichová, Dagmar Jeníčková, doc. MUDr. Bohdana Kalvodová, CSc

Univerzita Karlova v Praze, 1. lékařská fakulta, Oční klinika 1. LF a VFN

Uveitis is a non-specific term for inflammation of the iris, ciliary body and choroidea. Intraocular inflammation may consequently involve

adjacent structures (cornea, sclera, retina, optic disc) and result in visual acuity impairment. The disease may be caused by infection,

autoimmune mechanisms or ocular injury. In just about 50 % of cases the cause of intraocular inflammation is unknown. The main presumption

for commencement of causal treatment is to recognize the etiology of uveitis. Treatment options depend on inflammation

severity, frequency of complications and threat of visual acuity owing to uveitis. Mild accidental cases of uveitis require treatment different

from that of chronic or recurrent uveitis, especially when the latter is associated with systemic disease. Furthermore, infectious or

neoplastic diseases demand specific treatment. The main aims of therapy are to minimalize inflammatory activity, to prevent sight-threatening

complications, to preserve the best possible visual acuity and to relieve the patient’s discomfort. In the case of infectious uveitis,

treatment is based on the causative agent and thus the appropriate virostatics, antibiotics, chemotherapeutics, anti-fungal drugs and

anthelmintics are used. Non-infectious uveitis therapy involves non-steroid anti-inflammatory drugs, corticosteroids, immunosuppressive

drugs and biologic agents. Mydriatics and cycloplegics also play an important role in the treatment of uveitis. The main reason for their

application is prevention of posterior synechiae and relaxation of ciliary spasms. Immunosuppressive therapy administrated systemically

is indicated in cases of non-infectious sight-threatening uveitis. In approximately one third of cases, ocular autoimmune inflammation

is linked to systemic disease, for instance sarcoidosis, multiple sclerosis, systemic vasculitis (Wegener’s granulomatosis, systemic lupus

erythematodes, Behcet’s disease) and others. Treatment is then conducted in cooperation with a specialist in the related field.

Keywords: uveitis, intraocular inflammation, corticosteroids, immunosuppression, biologic agents.

Published: November 6, 2009  Show citation