Gamalero Lisa, Simonini Gabriele, Ferrara Giovanna, Polizzi Silvio, Giani Teresa, Cimaz Rolando
Department of Pediatric Rheumatology, Meyer Children University Hospital, Florence, Italy.
Department of Pediatric Ophthalmology, Meyer Children University Hospital, Florence, Italy.
Isr Med Assoc J. 2019 Jul;21(7):475-479.
Uveitis is an inflammatory disorder of the uveal tract of the eye that can affect both adults and children. Non-infectious uveitis can be an expression of a systemic autoimmune condition, or it can be idiopathic. It is a serious disease, associated with possible severe complications leading to visual impairment and blindness. For this reason, a prompt diagnosis and assessment of an appropriate treatment, with the collaboration of specialists such as ophthalmologists and rheumatologists, are extremely important. Many treatment options may be associated to side effects; therefore, clinicians should follow a stepladder approach starting with the least aggressive treatments to induce remission of inflammation. In this review, we reported the current evidence-based treatments for non-infectious uveitis in pediatric and adult patients with particular attention to the biologic response modifier treatment options. Important multicenter studies have demonstrated the efficacy of adalimumab, both in adults (VISUAL I, VISUAL II, VISUAL III) and in children (SYCAMORE, ADJUVITE), while for other agents data are still scarce.
葡萄膜炎是一种眼部葡萄膜的炎症性疾病,可影响成人和儿童。非感染性葡萄膜炎可能是全身性自身免疫性疾病的一种表现,也可能是特发性的。它是一种严重的疾病,可能伴有导致视力损害和失明的严重并发症。因此,在眼科医生和风湿病学家等专家的协作下,及时诊断并评估合适的治疗方法极为重要。许多治疗选择可能会有副作用;因此,临床医生应采用阶梯式方法,从最不激进的治疗开始,以诱导炎症缓解。在本综述中,我们报告了目前针对儿童和成人非感染性葡萄膜炎的循证治疗方法,特别关注生物反应调节剂治疗方案。重要的多中心研究已证明阿达木单抗在成人(VISUAL I、VISUAL II、VISUAL III)和儿童(SYCAMORE、ADJUVITE)中的疗效,而对于其他药物,数据仍然稀少。