McHarg Matthew, Young LeAnne, Kesav Natasha, Yakin Mehmet, Sen H Nida, Kodati Shilpa
National Eye Institute, National Institutes of Health, 10 Center Dr, 10/10N109, Bethesda, MD, 20892, USA.
George Washington University School of Medicine, Washington, DC, 20052, USA.
J Ophthalmic Inflamm Infect. 2022 Jan 4;12(1):3. doi: 10.1186/s12348-021-00281-z.
Regional corticosteroid therapy for noninfectious uveitis is well-established but usage patterns have not been studied extensively. This study aims to assess practice patterns of retina and uveitis specialists regarding their preferences on the use of local corticosteroid therapy.
A 13-question survey was developed regarding the practice patterns of regional corticosteroid use in specific situations and populations. The survey was distributed to both the American Uveitis Society and Macula Society.
Responses from 87 ophthalmologists were analyzed. The two most commonly used drugs were the dexamethasone intravitreal implant (Ozurdex®) and posterior sub-tenon's triamcinolone (also known as posterior sub-Tenon's Kenalog, or PSTK). Regional corticosteroids were used more frequently as first-line treatment in more than half of posterior uveitis cases when compared to anterior uveitis (39.1-46.0% vs 10.3%, respectively). Respondents were more willing to use regional corticosteroids in more than half of unilateral uveitis cases than in bilateral cases (54.7% vs 18.6%, respectively). A majority of respondents (67.1%) stated that they would avoid using regional corticosteroids in patients under 8 years old.
Our results demonstrate more frequent regional corticosteroid use in posterior segment uveitis, unilateral cases, and avoidance in younger pediatric patients. Overall, the variability in these responses highlights the need for guidelines regarding regional corticosteroid use.
局部使用皮质类固醇治疗非感染性葡萄膜炎已被广泛应用,但使用模式尚未得到广泛研究。本研究旨在评估视网膜和葡萄膜炎专科医生在局部使用皮质类固醇治疗方面的偏好及实践模式。
针对特定情况和人群中局部使用皮质类固醇的实践模式设计了一项包含13个问题的调查问卷。该问卷分发给了美国葡萄膜炎学会和黄斑学会。
分析了87位眼科医生的回复。两种最常用的药物是地塞米松玻璃体内植入剂(Ozurdex®)和后Tenon囊下曲安奈德(也称为后Tenon囊下康宁克通,或PSTK)。与前葡萄膜炎相比,在超过一半的后葡萄膜炎病例中,局部使用皮质类固醇作为一线治疗更为频繁(分别为39.1 - 46.0%和10.3%)。在超过一半的单眼葡萄膜炎病例中,受访者比双眼病例更愿意使用局部皮质类固醇(分别为54.7%和18.6%)。大多数受访者(67.1%)表示他们会避免在8岁以下的患者中使用局部皮质类固醇。
我们的结果表明,在后段葡萄膜炎、单眼病例中更频繁地使用局部皮质类固醇,而在年龄较小的儿科患者中避免使用。总体而言,这些回复的差异凸显了制定局部使用皮质类固醇指南的必要性。