Ramana S Moorthy1, Nikolas J S London, Sunir J Garg, Emmett T Cunningham. 1. aAssociated Vitreoretinal and Uveitis Consultants bEugene and Marilyn Glick Eye Institute and Department of Ophthalmology, Indiana University Medical Center cSt. Vincent Hospital and Health Services, Indianapolis, Indiana dRetina Consultants San Diego, La Jolla, California eMidAtlantic Retina, The Retina Service of Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania fDepartment of Ophthalmology, California Pacific Medical Center, San Francisco gThe Department of Ophthalmology, Stanford University School of Medicine, Stanford hWest Coast Retina Medical Group, San Francisco, California, USA.
Abstract
PURPOSE OF REVIEW: Although more than 50% of all uveitis cases have no identifiable cause, certain medications can cause ocular inflammation and are often overlooked. Drug-induced ocular inflammation has increased in frequency with the advent of new bisphosphonates, antitumor necrosis factor biologic agents, and intravitreal triamcinolone and antivascular endothelial growth factor medications. Identification of these inciting drugs will simplify work-up and management of patients with uveitis and improve visual outcomes. RECENT FINDINGS: This review briefly focuses on the drugs that have long been known to be strongly associated with uveitis and emphasize new observations about these associations. It will also highlight the newest medications associated with uveitis and scleritis. The strength of the association between each drug and uveitis will be quantified and categorized into definite, probable, possible, and unlikely causes of uveitis utilizing Naranjo's classification criteria. SUMMARY: Drug-induced uveitis has become increasingly recognized in association with a number of commonly used systemic, intraocular, and topical medications. A detailed history is often all that is needed to identify these important, often overlooked, and readily curable causes of uveitis. Most cases of drug-induced uveitis respond promptly to discontinuation of the suspected agent in conjunction with topical corticosteroid and cycloplegic therapy.
PURPOSE OF REVIEW: Although more than 50% of all uveitis cases have no identifiable cause, certain medications can cause ocular inflammation and are often overlooked. Drug-induced ocular inflammation has increased in frequency with the advent of new bisphosphonates, antitumor necrosis factor biologic agents, and intravitreal triamcinolone and antivascular endothelial growth factor medications. Identification of these inciting drugs will simplify work-up and management of patients with uveitis and improve visual outcomes. RECENT FINDINGS: This review briefly focuses on the drugs that have long been known to be strongly associated with uveitis and emphasize new observations about these associations. It will also highlight the newest medications associated with uveitis and scleritis. The strength of the association between each drug and uveitis will be quantified and categorized into definite, probable, possible, and unlikely causes of uveitis utilizing Naranjo's classification criteria. SUMMARY: Drug-induced uveitis has become increasingly recognized in association with a number of commonly used systemic, intraocular, and topical medications. A detailed history is often all that is needed to identify these important, often overlooked, and readily curable causes of uveitis. Most cases of drug-induced uveitis respond promptly to discontinuation of the suspected agent in conjunction with topical corticosteroid and cycloplegic therapy.
Authors: Muhammad Hassan; Arash Maleki; Qian Ying; Nam Nguyen; Muhammad Sohail Halim; Yasir J Sepah; Diana V Do; Quan Dong Nguyen Journal: Am J Ophthalmol Case Rep Date: 2019-01-09