title: Metoprolol responding uveitis.
abstract: BACKGROUND
  Noninfectious uveitis is usually managed by topical and systemic corticosteroids and in refractory cases by immunosuppressive drugs.
  
  
  OBJECTIVE
  To describe a patient with noninfectious anterior and posterior uveitis, refractory to corticosteroids, and immunosuppressive therapy, which responded to systemic metoprolol.
  
  
  METHODS
  A 49-year-old patient was treated for 3 years with topical and systemic corticosteroids and systemic cyclosporin A for a bilateral anterior and posterior uveitis of unknown origin. The treatment did not result in resolution of the uveitis. A bilateral uveitic glaucoma developed and necessitated neodymium : YAG laser iridotomies and antiglaucoma medications. A systemic beta-blocker, metoprolol tartrate 50 mg b.i.d., was administered for palpitations because of idiopatic paroxysmal supraventricular tachycardia and short ventricular tachycardia.
  
  
  RESULTS
  Following administration of metoprolol tartrate, the bilateral uveitis resolved. The corticosteroids and the cyclosporin A were withdrawn after 6 weeks without any recurrence. A trial to discontinue metoprolol after 6 months resulted in flare-up of the disease and only following its readministration the inflammation resolved. The patient is currently under metoprolol for a year without flare-ups.
  
  
  CONCLUSIONS
  The use of metoprolol tartrate in this patient resulted in resolution of bilateral noninfectious uveitis. This is the first report of non-antiinfectious, antiinflammatory, or immunosuppressive drug effective for uveitis. It is possible that a subgroup of resistant uveitis may respond to drugs other than the traditional drugs, such as metoprolol, and that other forms of uveitis of unidentified origin exist.
authors.affiliation: 1Department of Ophthalmology, Western Galilee, Nahariya Medical Center, Nahariya, Israel.
authors.forename: Y
authors.initials: Y
authors.lastname: Kassif
authors.forename: U
authors.initials: U
authors.lastname: Rehany
authors.forename: S
authors.initials: S
authors.lastname: Rumelt
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D004351:Drug Resistance; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008790:Metoprolol / Q000627:therapeutic use*; D008875:Middle Aged; D014606:Uveitis, Anterior / Q000188:drug therapy*; D015866:Uveitis, Posterior / Q000188:drug therapy*
chemical_list: D000319:Adrenergic beta-Antagonists; D008790:Metoprolol