Academic Unit of Ophthalmology, School of Immunity and Infection, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
Ocul Immunol Inflamm. 2011 Oct;19(5):353-7. doi: 10.3109/09273948.2011.592260. Epub 2011 Aug 8.
To survey the practice of uveitis experts in the management of uveitic cataract and cystoid macular oedema (CMO).
A structured questionnaire containing two clinical scenarios was sent to members of the International Uveitis Study Group (IUSG). The questionnaire surveyed both respondents' current practice and their perception of the supporting clinical evidence.
For uveitic cataract, 70% required a 3-month inflammation-free period before surgery, and 76% gave a prophylactic preoperative systemic corticosteroid. For uveitic CMO, 87% gave corticosteroids, usually orally. Preferred second-line agents were methotrexate (39%), cyclosporin (24%), azathioprine (17%), and mycophenolate (7%). Respondents suggested the evidence underlying their decisions was either absent or relatively weak (levels III or IV), and in most cases personal experience was a factor.
This survey highlights areas of consensus and variation among uveitis experts in managing uveitic cataract and CMO, and emphasizes the need for further clinical trials to establish the best practice.
调查葡萄膜炎专家在治疗葡萄膜炎性白内障和囊样黄斑水肿（CMO）方面的实践情况。
向国际葡萄膜炎研究组（IUSG）的成员发送了一份包含两个临床情况的结构化问卷。该问卷调查了受访者目前的实践情况及其对支持临床证据的看法。
对于葡萄膜炎性白内障，70%的人需要在手术前有 3 个月的炎症缓解期，76%的人给予预防性术前全身皮质类固醇。对于葡萄膜炎性 CMO，87%的人给予皮质类固醇，通常是口服。首选的二线药物是甲氨蝶呤（39%）、环孢素（24%）、硫唑嘌呤（17%）和霉酚酸酯（7%）。受访者表示，他们决策的依据要么不存在，要么相对较弱（III 或 IV 级），在大多数情况下，个人经验是一个因素。
这项调查突出了葡萄膜炎专家在治疗葡萄膜炎性白内障和 CMO 方面的共识和差异领域，并强调需要进一步进行临床试验以确定最佳实践。
