Current therapeutic approaches to autoimmune chronic uveitis in children.
Uveitis is an inflammatory disorder involving inflammation of the uveal tract. It is classified as anterior, intermediate, posterior or panuveitis, depending on the part of eye affected by the inflammatory process. In children, non-infectious, chronic uveitis is a relatively uncommon but serious disease, with the potential for significant long-term complications and possible blindness. Although frequently associated with an underlying systemic disease, e.g. juvenile idiopathic arthritis (JIA), a significant number of cases in children show no associated signs or symptoms, and are labelled as idiopathic. Taking into account this evidence, an anti-inflammatory therapy based on an immuno-modulatory approach seems a reasonable strategy for non-infectious chronic uveitis, in children as well as in adults. Due to a lack of controlled studies regarding uveitis in children, immunosuppressive drugs are supported only at evidence level III. The aim of this review is to report currently available medical strategies for treatment of childhood sight-threatening chronic uveitis; in addition, a step-by-step approach to the use of immunosuppressants in this context is suggested.
Simonini
Gabriele
G
Department of Paediatrics, Anna Meyer Children's Hospital, University of Florence, Italy. gabriele.simonini@unifi.it
Cantarini
Luca
L
Bresci
Cecilia
C
Lorusso
Monica
M
Galeazzi
Mauro
M
Cimaz
Rolando
R
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D001171:Arthritis, Juvenile / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D001327:Autoimmune Diseases / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D001766:Blindness; D002648:Child; D002908:Chronic Disease; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008727:Methotrexate / Q000627:therapeutic use*; D017410:Practice Guidelines as Topic; D014605:Uveitis / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology
D000305:Adrenal Cortex Hormones; D007166:Immunosuppressive Agents; D008727:Methotrexate