M Castillejo Becerra Clara, Ding Yue, Kenol Beatrice, Hendershot Andrew, Meara Alexa Simon
College of Medicine, Ohio State University, Columbus, Ohio, USA.
Division of Rheumatology and Immunology, Ohio State University, Columbus, Ohio, USA.
BMJ Open Ophthalmol. 2020 Jan 7;5(1):e000331. doi: 10.1136/bmjophth-2019-000331. eCollection 2020.
This paper reviews the ocular side effects of medications used in the treatment of rheumatological conditions.
Rheumatic diseases are inflammatory conditions that may affect the skin, blood vessels, joints, muscles and internal organs. Immunosuppressive agents are often used as treatment and while powerful, they carry side effects and toxicities that need careful monitoring. Ophthalmic complications have been reported with the use of antirheumatic medications; however, there is a lack of literature synthesising these reports. This paper addresses this gap and hopes to inform both rheumatologists and ophthalmologists as they work together on the management of patients with rheumatological conditions.
PubMed literature search was conducted from November to September 2019 searching for ocular side effects with the use of 25 rheumatological drugs.
A total of 111 papers were included in this review. Adverse side effects were divided into non-infectious and infectious causes. Traditional disease-modifying antirheumatic drugs (DMARDs) were associated with pruritus, irritation and dryness of the conjunctiva while biologic DMARDS showed reports of new-onset/recurrent uveitis and demyelinating conditions. Infectious side effects included episodes of cytomegalovirus retinitis, toxoplasmic chorioretinitis and endophthalmitis. Other serious side effects were encountered and included in this review.
The goal of this paper is to inform healthcare providers about potential ocular side effects from rheumatological medications. Healthcare providers are encouraged to learn more about these ophthalmic complications and find relevance within their clinical practice.
本文综述了用于治疗风湿性疾病的药物的眼部副作用。
风湿性疾病是炎症性疾病，可能影响皮肤、血管、关节、肌肉和内脏器官。免疫抑制剂常被用作治疗药物，虽然药效强大，但它们会带来副作用和毒性，需要仔细监测。使用抗风湿药物时已报告有眼部并发症；然而，缺乏综合这些报告的文献。本文填补了这一空白，希望能为风湿科医生和眼科医生在共同管理风湿性疾病患者时提供参考。
于2019年11月至9月在PubMed上进行文献检索，以查找使用25种风湿性药物时的眼部副作用。
本综述共纳入111篇论文。不良反应分为非感染性和感染性原因。传统的改善病情抗风湿药物（DMARDs）与结膜瘙痒、刺激和干燥有关，而生物DMARDs则有新发/复发性葡萄膜炎和脱髓鞘疾病的报告。感染性副作用包括巨细胞病毒性视网膜炎、弓形虫性脉络膜视网膜炎和眼内炎发作。还遇到了其他严重副作用并纳入本综述。
本文的目的是告知医疗服务提供者有关风湿性药物潜在的眼部副作用。鼓励医疗服务提供者更多地了解这些眼科并发症，并在其临床实践中找到相关性。
