Department of Ophthalmology, Charité - Universitätsmedizin, Berlin Institute of Health, 13353, Berlin, Germany.
Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE.
Int Ophthalmol. 2021 Jun;41(6):2265-2281. doi: 10.1007/s10792-021-01763-8. Epub 2021 Feb 25.
Noninfectious inflammation of the posterior eye segment represents an important cause of visual impairment. It often affects relatively young people and causes a significant personal and social impact. Although steroids and nonbiologic- Disease-Modifying Antirheumatic Drugs (nbDMARDs) are effective both in acute and long- lasting diseases, however they are increasingly being replaced by biologic (DMARDs). bDMARD. This article therefore aims to identify recent advances in the therapy of noninfectious posterior segment uveitis.
A Medline-search was conducted using the terms: nbDMARD, bDMARD, posterior uveitis, intermediate uveitis, treatment, corticosteroid. In addition, clinical studies were included as registered at ClinicalTrials.gov.
Currently two major lines of treatments can be identified: (1) the intraocular application of anti-inflammatory agents and (2) the introduction of new agents, e.g., (bDMARDs) and small-molecule-inhibitors. Whereas intravitreal treatments have the advantage to avoid systemic side effects, new systemic agents are progressively earning credit on the basis of their therapeutic effects.
Even when current treatment strategies are still hampered by the limited number of randomized controlled trials, promising progress and continuous efforts are seen.
眼后段非传染性炎症是视力损害的一个重要原因。它常影响相对年轻的人群，并造成重大的个人和社会影响。尽管皮质类固醇和非生物疾病修正抗风湿药物（nbDMARDs）在急性和长期疾病中均有效，但它们正越来越多地被生物制剂（DMARDs）所取代。本文旨在探讨非感染性眼后段葡萄膜炎治疗的最新进展。
使用以下术语在 Medline 上进行了搜索：nbDMARD、bDMARD、后葡萄膜炎、中间葡萄膜炎、治疗、皮质类固醇。此外，还将在 ClinicalTrials.gov 上注册的临床研究纳入其中。
目前可以确定两种主要的治疗方法：（1）眼内应用抗炎药物，（2）引入新的药物，如（bDMARDs）和小分子抑制剂。虽然玻璃体内治疗具有避免全身副作用的优势，但新的全身药物正在基于其治疗效果而逐渐获得认可。
尽管当前的治疗策略仍然受到随机对照试验数量有限的限制，但仍在不断取得有希望的进展和努力。
