Ophthalmology Department, University Hospitals Birmingham NHS Trust, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham, B15 2WB, UK.
BMC Ophthalmol. 2013 Apr 24;13:18. doi: 10.1186/1471-2415-13-18.
In this review we consider the current evidence base for treatments in inflammatory eye disease, and in particular uveitis, from a historical perspective. We consider the challenges that have traditionally hindered progress in inflammatory eye disease including small target populations, heterogeneous disease groups, poorly defined phenotypes, diagnostic inconsistency, subjective outcome measures, specific issues around visual acuity as an outcome measure and low commercial interest. Strategies to address these issues are considered de novo and with reference to recent advances outside of ophthalmology and highlight the promise for ocular inflammation. Progress in these specialties has included the development of thriving clinical-trial cultures, public-private partnerships, pathogenetic- and structure-led drug design, efficient drug development pipelines, and biomarker-defined treatment protocols enabling personalization of medicine. Although there are challenges, these are exciting opportunities as we seek to develop safe and effective treatments for patients with inflammatory eye disease.
在这篇综述中，我们从历史的角度考虑了目前在炎症性眼病治疗方面，特别是葡萄膜炎方面的证据基础。我们考虑了传统上阻碍炎症性眼病进展的挑战，包括目标人群小、疾病群体异质性、表型定义不明确、诊断不一致、主观结果测量、视力作为结果测量的具体问题以及商业利益低。这些问题的解决策略是从头开始考虑的，并参考了眼科学以外的最新进展，强调了眼部炎症的前景。这些专业领域的进展包括发展蓬勃的临床试验文化、公私合作伙伴关系、基于发病机制和结构的药物设计、高效的药物开发管道以及基于生物标志物的治疗方案，从而实现药物的个性化。尽管存在挑战，但这些都是令人兴奋的机会，因为我们试图为炎症性眼病患者开发安全有效的治疗方法。
