Knickelbein Jared E, Kim Meredith, Argon Elvira, Nussenblatt Robert B, Sen Nida H
National Eye Institute, National Institutes of Health, Bethesda, MD.
Expert Rev Ophthalmol. 2017;12(4):313-319. doi: 10.1080/17469899.2017.1319762. Epub 2017 Apr 26.
Non-infectious uveitis encompasses a group of inflammatory eye diseases that can cause irreversible vision loss if left untreated or undertreated. In cases requiring stemic treatment, a step-wise treatment approach is often employed starting with corticosteroids for severe active disease, followed by initiation of steroid-sparing therapies to maintain inflammatory control and avoid the abundant complications of long-term corticosteroid use.
We review the current high-quality evidence comparing the efficacy of various systemic steroid-sparing agents in the treatment of non-infectious uveitis. For studies to be included, they had to have a prospective, randomized, comparative design or a retrospective design including at least 100 patients.
Given the rarity of uveitis and the heterogeneity of uveitic diseases, there are few randomized controlled studies that directly compare the relative efficacy of the various steroid-sparing immunosuppressive agents. Therefore, current treatment strategies are based mainly on data from observational series.
非感染性葡萄膜炎是一组炎症性眼病，如果不治疗或治疗不足，可导致不可逆的视力丧失。在需要全身治疗的情况下，通常采用逐步治疗方法，对于严重的活动性疾病，首先使用皮质类固醇，然后开始使用类固醇节省疗法以维持炎症控制并避免长期使用皮质类固醇的大量并发症。
我们回顾了目前比较各种全身类固醇节省药物治疗非感染性葡萄膜炎疗效的高质量证据。纳入的研究必须具有前瞻性、随机、比较设计或至少包括100名患者的回顾性设计。
鉴于葡萄膜炎的罕见性和葡萄膜炎疾病的异质性，很少有随机对照研究直接比较各种类固醇节省免疫抑制剂的相对疗效。因此，目前的治疗策略主要基于观察性系列的数据。
