Drug-induced uveitis

Moorthy, Ramana S.; London, Nikolas; Garg, Sunir J.; Cunningham, Emmett T.

doi:10.1097/01.icu.0000434534.32063.5c

Cited by 57 publications

(36 citation statements)

References 132 publications

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“…Finally, several drugs with indications in diseases pertaining to different areas of medicine (such as cidofovir, anti-mycobacterial antibiotics, bisphosphonates, sulfonamides, tumor necrosis factor-a inhibitors, oral fluoroquinolones, and anti-vascular endothelial growth factor monoclonal antibodies) may uncommonly be associated with uveitis [48,49]. Often overlooked or misdiagnosed in the past, drug-induced uveitis is now increasingly recognized, thus becoming an important step of the uveitis diagnostic algorithm.…”

Section: 4%mentioning

confidence: 97%

“…The second point is the need, of careful reviewing all current and previous drugs that the AU patient has been given, in which systemic, periocular, intravitreal, and topical medications have long been recognized as potentially responsible for drug-induced ocular inflammation [48][49][50]. The prompt recognition of drug-induced uveitis and the consequent discontinuation of the inciting drug usually result in regression of the ocular inflammatory process, thus avoiding the administration of additional, unnecessary drugs and the possible irreversible impairment of the visual function.…”

Section: Treatment Of Autoimmune Uveitismentioning

confidence: 99%

“…Patients with druginduced uveitis commonly present with moderate-to-severe non-granulomatous anterior uveitis, scleritis and episcleritis that develop 1-3 weeks after the administration of a systemic, intraocular, or topical drug. Discontinuation of the suspected drug(s) and/or addition of topic corticosteroids and cycloplegic therapy is usually followed by resolution of the ocular inflammation [48].…”

Section: 4%mentioning

confidence: 99%

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Autoimmune uveitis: clinical, pathogenetic, and therapeutic features

et al. 2015

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Autoimmune uveitis (AU), an inflammatory non-infectious process of the vascular layer of the eye, can lead to visual impairment and, in the absence of a timely diagnosis and suitable therapy, can even result in total blindness. The majority of AU cases are idiopathic, whereas fewer than 20 % are associated with systemic diseases. The clinical severity of AU depends on whether the anterior, intermediate, or posterior part of the uvea is involved and may range from almost asymptomatic to rapidly sight-threatening forms. Race, genetic background, and environmental factors can also influence the clinical picture. The pathogenetic mechanism of AU is still poorly defined, given its remarkable heterogeneity and the many discrepancies between experimental and human uveitis. Even so, the onset of AU is thought to be related to an aberrant T cell-mediated immune response, triggered by inflammation and directed against retinal or cross-reactive antigens. B cells may also play a role in uveal antigen presentation and in the subsequent activation of T cells. The management of AU remains a challenge for clinicians, especially because of the paucity of randomized clinical trials that have systematically evaluated the effectiveness of different drugs. In addition to topical treatment, several different therapeutic options are available, although a standardized regimen is thus far lacking. Current guidelines recommend corticosteroids as the first-line therapy for patients with active AU. Immunosuppressive drugs may be subsequently required to treat steroid-resistant AU and for steroid-sparing purposes. The recent introduction of biological agents, such as those targeting tumor necrosis factor-α, is expected to remarkably increase the percentages of responders and to prevent irreversible sight impairment. This paper reviews the clinical features of AU and its crucial pathogenetic targets in relation to the current therapeutic perspectives. Also, the largest clinical trials conducted in the last 12 years for the treatment of AU are summarized and critically discussed.

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Section: 4%mentioning

confidence: 97%

Section: Treatment Of Autoimmune Uveitismentioning

confidence: 99%

Section: 4%mentioning

confidence: 99%

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Autoimmune uveitis: clinical, pathogenetic, and therapeutic features

et al. 2015

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“…Furthermore, the ophthalmological outcome excluded Fuchs heterochromic iridocyclitis and Posner-Schlossman syndrome. In addition, several drugs including cidofovir and rifabutin are reported to induce uveitis [ 6 ]. In the present study, neither patient had taken those medicines during the period in which they contracted uveitis.…”

Section: Discussionmentioning

confidence: 99%

Association of Cryptogenic Organizing Pneumonia in Bilateral Anterior Uveitis

Fujimoto

Hiraoka

Inatomi

et al. 2014

Case Rep Ophthalmol

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Two female patients with histories of cancer who showed cryptogenic organizing pneumonia (COP) complications and bilateral anterior uveitis with hypopyon were examined. Both patients had suffered from COP and received intermitted systemic corticosteroid administration (SCA). The first patient, a 65-year-old woman with a history of breast cancer, showed bilateral uveitis with hypopyon. The topical corticosteroid treatment was ineffective. After SCA for the treatment of COP was started, the hypopyon gradually dissipated. Upon termination of SCA, uveitis relapses were controlled by renewed SCA. The other patient, a 69-year-old woman with a history of ovarian cancer, showed bilateral anterior uveitis with hypopyon. Her intraocular outcome did not improve by the topical corticosteroid administration, but SCA that was applied to treat COP led to remission of uveitis. Imaging examinations, biochemical analysis, symptoms or HLA-B27 antigen screenings in either patient did not explain the development of uveitis. Bilateral anterior uveitis is commonly related to autoimmune disease or systemic syndrome. We report two cases with COP that developed bilateral anterior uveitis with hypopyon resistant to topical administration but responsive to systemic administration of corticosteroid. These findings suggest that COP can be associated with the etiology of anterior uveitis.

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“…6,7 Several summaries of vaccine-associated uveitis have appeared over the past decade. [8][9][10][11][12][13][14][15] In the most comprehensive review from 2016, 10 Benage and Fraunfelder identified 289 cases using Medline literature searches and a systematic review of three surveillance systems: the National registry of Drug-Induced Ocular Side Effects (www.eyedrugregistry.com), the UMC, and the VAERS. Vaccination for hepatitis B virus (HBV), 15 either alone or in combination, was reported most frequently (40.5%), followed by immunization for human papillomavirus (HPV; 15.6%), 12 influenza virus (9.7%), Bacille Calmette-Guerin (BCG; 7.3%), measles-mumps-rubella (MMR) alone or in combination (4.8%), varicella virus alone or in combination (4.8%), and hepatitis A virus (HAV) alone or in combination (2.4%).…”

mentioning

confidence: 99%