title: Treating chronic noninfectious posterior segment uveitis: the impact of cumulative damage. Proceedings of an expert panel roundtable discussion.
abstract: Chronic noninfectious posterior segment uveitis refers to inflammation of the retina, choroid, vitreous, or optic nerve, and may result in permanent vision loss. The inflammation can be constant, or characterized by periodic exacerbations on an underlying baseline of inflammation. Recent studies indicate that this vision loss often results from cumulative damage over multiple recurrences of inflammation, rather than from a single initiating event. Most forms of local therapy provide only transient suppression of inflammation, and the use of systemic agents may be limited by serious side effects. The course of uveitis may, therefore, be marked by recurrent episodes of inflammation, each contributing to progressive and permanent loss of visual acuity. The goal of uveitis treatment should not only be to suppress inflammation when it recurs but also to attain complete remission of inflammation, and thus prevent complications such as cystoid macular edema (CME) and permanent cumulative damage. The RETISERT intravitreal implant offers sustained local control of inflammation without the systemic side effects that limit standard immunosuppressive and oral corticosteroid therapies. The recommendation of the expert panel was that RETISERT is a useful addition to the armamentarium for the treatment of chronic noninfectious posterior segment uveitis and may help to prevent cumulative damage from repeated occurrences of inflammation, especially when vision can be improved rather than only stabilized.
authors.affiliation: Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors.forename: Quan Dong
authors.initials: QD
authors.lastname: Nguyen
authors.forename: David
authors.initials: D
authors.lastname: Callanan
authors.forename: Pravin
authors.initials: P
authors.lastname: Dugel
authors.forename: David G
authors.initials: DG
authors.lastname: Godfrey
authors.forename: Debra A
authors.initials: DA
authors.lastname: Goldstein
authors.forename: Jacob T
authors.initials: JT
authors.lastname: Wilensky
mesh_terms: D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D004343:Drug Implants; D005446:Fluocinolone Acetonide / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007267:Injections; D015866:Uveitis, Posterior / Q000188:drug therapy*; D014792:Visual Acuity; D014822:Vitreous Body
chemical_list: D000893:Anti-Inflammatory Agents; D004343:Drug Implants; D005446:Fluocinolone Acetonide