Byers Eye Institute, Stanford University School of Medicine, Palo Alto, California, USA.
Department of Surgery, Division of Ophthalmology, Kobe University Graduate School of Medicine, Kobe, Japan.
Ocul Immunol Inflamm. 2024 Oct;32(8):1832-1843. doi: 10.1080/09273948.2023.2296032. Epub 2024 Feb 8.
The index review aims to provide an update on the role of corticosteroids and steroid-sparing immunomodulatory therapy (IMT) in managing patients with infectious uveitis.
Narrative literature review.
Corticosteroids and immunomodulatory therapy (IMT) focus on the host defense system instead of the pathogen, adjusting exaggerated inflammatory reactions to reduce potential harm to ocular tissues. Systemic or local corticosteroids are primarily selected as adjunctive medication for infectious uveitis. Concomitant corticosteroids have also been used in cases of paradoxical worsening in ocular tuberculosis and immune recovery uveitis in cytomegalovirus (CMV) retinitis. While there is no well-established evidence to support the use of IMT in infectious uveitis, it is occasionally used in clinical settings to treat persistent inflammation following resolution of infection such as cases of ocular tuberculosis and ocular syphilis where an insufficient response is observed with corticosteroids.
There is no consensus on the position of immunomodulatory therapy in the management of infectious uveitis with different etiologies. The index review provides an overview of available adjunctive corticosteroids and IMT options to assist clinicians in managing such disease entities more efficiently.
本次综述旨在提供关于皮质类固醇和免疫调节治疗（IMT）在治疗感染性葡萄膜炎患者中的作用的最新信息。
叙述性文献综述。
皮质类固醇和免疫调节治疗（IMT）专注于宿主防御系统而不是病原体，调节过度的炎症反应，以减少对眼组织的潜在损害。全身性或局部皮质类固醇通常被选为感染性葡萄膜炎的辅助药物。皮质类固醇也被用于治疗结核性眼内炎和巨细胞病毒（CMV）视网膜炎的免疫恢复性葡萄膜炎中出现的矛盾性恶化。虽然没有充分的证据支持在感染性葡萄膜炎中使用 IMT，但在临床实践中偶尔会使用，例如在感染消退后仍存在持续性炎症的情况下，如结核性眼内炎和眼梅毒，皮质类固醇治疗效果不佳时。
对于不同病因的感染性葡萄膜炎，免疫调节治疗的地位尚未达成共识。本综述提供了可用的辅助皮质类固醇和 IMT 选择的概述，以帮助临床医生更有效地治疗这些疾病实体。
