Clinical Trials in PU
Posterior uveitis is inflammation in the uvea tissues of the eye that can cause vision loss. Anterior, intermediate, posterior, and panuveitis are the four types of uveitis. The inflammatory diseases that comprise uveitis cause 10% to 15% of blindness cases around the world. [Lowder.Arch Ophthalmol.2011] Nonsteroidal anti-inflammatory drugs, corticosteroids, and immunomodulatory therapy are the mainstay treatments for posterior uveitis. Antibiotics or antiviral medications are also used if there is an infectious cause. Steroid therapy has evolved to include more intravitreal administration in addition to topical or systemic use. The side effects of steroid therapy, including cataract formation, glaucoma, diabetes, and hypertension must be considered. The use of anti-vascular endothelial growth factor agents are not as well-studied for posterior uveitis treatment or uveitis in general. [McKay KM, Leveque TK.RetinaSpecialist.2021]
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References
Jaffe GJ, Dick AD, Brézin AP, et al. Adalimumab in patients with active noninfectious uveitis. N Engl J Med. 2016; 375:932-943. https://www.nejm.org/doi/10.1056/NEJMoa1509852
Lowder C, Belfort R, Lightman S, et al. Dexamethasone intravitreal implant for noninfectious intermediate or posterior uveitis. Arch Ophthalmol. 2011;129:545-553. https://jamanetwork.com/journals/jamaophthalmology/article-abstract/427281
McKay KM, Leveque TK. Using anti-VEGF agents in uveitis. Retina Specialist. Published September 30, 2021. https://www.retina-specialist.com/article/using-antivegf-agents-in-uveitis
The Multicenter Uveitis Steroid Treatment (MUST) Research Group, Kempen JH, Atlaweel MM, et al. Randomized comparison of systemic anti-inflammatory therapy versus fluocinolone acetonide implant for intermediate, posterior, and panuveitis: The Multicenter Uveitis Steroid Treatment Trial. Ophthalmology. 2011;118:1916-1926. https://www.aaojournal.org/article/S0161-6420(11)00681-6/fulltext
The Multicenter Uveitis Steroid Treatment Trial (MUST) Research Group, Thorne JE, Sugar EA, et al. Periocular triamcinolone versus intravitreal triamcinolone versus intravitreal dexamethasone implant for the treatment of uveitic macular edema: The PeriOcular versus INTravitreal corticosteroids for uveitic macular edema (POINT) Trial. Ophthalmology. 2019;126:283-295. https://www.aaojournal.org/article/S0161-6420(18)31133-3/fulltext
Rathinam SR, Gonzales JA, Thundikandy R, et al. Effect of corticosteroid-sparing treatment with mycophenolate mofetil vs methotrexate on inflammation in patients with uveitis. A randomized controlled trial. JAMA. 2019;322:936-945. https://jamanetwork.com/journals/jama/fullarticle/2749597
Sugar EA, Venugopal V, Thorne JE, et al. Longitudinal vision-related quality of life for patients with noninfectious uveitis treated with fluocinolone acetonide implant or systemic corticosteroid therapy. Ophthalmology. 2017;124:1662-1669. https://www.aaojournal.org/article/S0161-6420(16)32265-5/fulltext
