Indian Journal of Ophthalmology (Jan 2020)

Systemic immunosuppressive therapies for uveitis in developing countries

  • Hitesh Agrawal,
  • Hien Doan,
  • Brandon Pham,
  • Amit Khosla,
  • Manohar Babu,
  • Peter McCluskey,
  • Quan Dong Nguyen,
  • Virender Sangwan,
  • Subhakar Reddy,
  • Sujata Sawhney,
  • Mudit Tyagi

DOI
https://doi.org/10.4103/ijo.IJO_1548_20
Journal volume & issue
Vol. 68, no. 9
pp. 1852 – 1862

Abstract

Read online

There are multiple approaches to inhibit inflammatory molecules and pathways in noninfectious uveitis. The cornerstone of local and systemic anti-inflammatory treatment is corticosteroid therapy. Corticosteroids remain the most potent and efficacious drugs for treating intraocular inflammation. However, their long-term use is limited by their medium- and long-term side effects, which are a major concern. The approach taken to limit corticosteroid side effects is to introduce steroid-sparing agents that suppress the inflammatory pathways and immune response differently than corticosteroids. There are several classes of such drugs that are affordable, effective, and generally well-tolerated. Relatively recently, an increasing range of biologic agents has become available to treat intraocular inflammation. However, the relatively expensive cost of these therapies limits their use in the developing world. This systemic review aimst to discuss the use of corticosteroids and different immunosuppressive regimens in the management of various uveitides.

Keywords