Systemic Management of Posterior Uveitis

Abstract

In the treatment of uveitis, corticosteroids are usually included in first-line therapy due to its rapid onset of action and excellent safety profile. Systemic immunosuppressive agents also play an important role in the management of posterior uveitis. The purpose of this study was to review systemic agents for treating uveitis: prednisone, methotrexate, cyclosporine, and azathioprine. This study was a review of the literature using Medline. Thirty-eight references were incorporated. Immunosuppressants take several weeks for their full effect and are considered when long-term therapy is anticipated. When long-term therapy is anticipated, immunosuppressant agents may be added, which allows for the reduction and eventual discontinuation of prednisone. Combination therapy of various immunosuppressants also allows for long-term therapy, which reduces the relapse rate. However, immunosuppressives can be associated with serious side-effects. The use of immunosuppressants requires careful monitoring.