General principles for the treatment of non-infectious uveitis.
Ocular inflammatory disorders constitute a sight-threatening group of diseases that might be managed according to their severity. Their treatment guidelines experience constant changes with new agents that improve the results obtained with former drugs. Nowadays we can make use of a five step protocol in which topical, periocular and systemic corticosteroids remain as the main therapy for non infectious uveitis. In addition, immunosuppresive drugs can be added in order to enhance the anti-inflammatory effects and to develop the role of corticosteroid-saving agents. These can be organized in four other steps: Cyclosporine and Methotrexate in a second one; Azathioprine, Mycophenolate Mofetil and Tacrolimus in a third step; biological anti-TNF drugs in fourth position; and a theoretical last one with Cyclophosphamide and Chlorambucil. In the present review we go through the main characteristics and complications of all these treatments and make a rational of this five-step treatment protocol for non infectious posterior uveitis.
Díaz-Llopis
Manuel
M
La Fe University Hospital of Valencia. Ophthalmology Department, Spain.
Gallego-Pinazo
Roberto
R
García-Delpech
Salvador
S
Salom-Alonso
David
D
D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use*; D000963:Antimetabolites / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D007167:Immunotherapy; D014605:Uveitis / Q000276:immunology / Q000503:physiopathology / Q000628:therapy*
D000911:Antibodies, Monoclonal; D000963:Antimetabolites; D007166:Immunosuppressive Agents