Clinical spectrum of blunted foveal contour

Therapeutic Advances in Ophthalmology

article

Ahmad Abdel-Aty¹  Akash Gupta²  Lucian Del Priore¹  Ninani Kombo¹ 

[1] Department of Ophthalmology and Visual Science, School of Medicine, Yale University;Department of Medicine, School of Medicine, Yale University

关键词: alkylating agents;    antimetabolites;    biologics;    calcineurin inhibitors;    corticosteroids;    immunomodulators;    inflammatory eye disease;    NSAIDs;    ocular inflammatory disease;    scleritis;    TNF-α inhibitors;   

DOI  :  10.1177/25158414211070879

学科分类：社会科学、人文和艺术（综合）

来源: Gdansk University Of Physical Education And Sport

【 摘 要 】

Scleritis is a manifestation of inflammatory eye disease that involves the sclera. It can be divided into multiple subtypes, including diffuse anterior, nodular anterior, necrotizing, and posterior scleritis. In many cases, scleritis is restricted to the eye; however, it can occur in the context of systemic illness, particularly autoimmune and infectious conditions. Patients with autoimmune conditions, such as rheumatoid arthritis, inflammatory bowel disease, systemic lupus erythematosus, and polyangiitis with granulomatosis, may develop scleritis flares that may require topical and systemic therapy. Initial therapy typically involves oral nonsteroidal anti-inflammatory drugs (NSAIDs); however, it is important to address the underlying condition, particularly if systemic. Other treatment regimens typically involve either local or systemic steroids or the use of immunomodulatory agents, which have a wide range of efficacy and documented use in the literature. There is a myriad of immunomodulatory agents used in the treatment of scleritis including antimetabolites, calcineurin inhibitors, biologics, and alkylating agents. In this review, we highlight the various subtypes of noninfectious scleritis and explore each of the mainstay agents used in the management of this entity. We explore the use of steroids and NSAIDs in detail and discuss evidence for various immunomodulatory agents.

【 授权许可】

CC BY|CC BY-NC