Claudia Fabiani1, Jorge L Alió. 1. aOphthalmology Unit, Department of Sense Organs, Policlinico Umberto I, Sapienza University of Rome, Italy bVissum Corporation cDivision of Ophthalmology, Universidad Miguel Hernández, Alicante, Spain.
Abstract
PURPOSE OF REVIEW: The purpose of this review is to outline agents currently in use for the local anti-inflammatory therapy of ocular Adamantiades-Behçet's disease (ABD), as well as those in translation from the laboratory to clinical use. RECENT FINDINGS: Novel formulations and innovative intraocular delivery strategies have been recently applied to treat intraocular inflammation in ABD. SUMMARY: ABD is a chronic multisystemic vasculitic disease with the highest prevalence in the Mediterranean basin and in the Eastern region of Asia. Bilateral autoimmune uveitis, oral and genital aphthous and skin lesions are the historically described triad. ABD uveitis is chronic relapsing and often sight-threatening and, according to the actual guidelines, to limit posterior segment involvement and prevent visual impairment high-dose and long-term systemic anti-inflammatory treatment is indicated. Corticosteroids, both topically and systemically, are the most effective treatment in the acute phase. To overcome the well known side-effects of corticosteroids over the long period, steroid-sparing drugs have been systemically administered showing positive results but having limited safety profile. To potentiate the intraocular pharmacological efficacy of these molecules in refractory ABD uveitis and to circumvent the risks of systemic administration, novel topical and intravitreal formulations and innovative delivering systems have been recently developed.
PURPOSE OF REVIEW: The purpose of this review is to outline agents currently in use for the local anti-inflammatory therapy of ocular Adamantiades-Behçet's disease (ABD), as well as those in translation from the laboratory to clinical use. RECENT FINDINGS: Novel formulations and innovative intraocular delivery strategies have been recently applied to treat intraocular inflammation in ABD. SUMMARY: ABD is a chronic multisystemic vasculitic disease with the highest prevalence in the Mediterranean basin and in the Eastern region of Asia. Bilateral autoimmune uveitis, oral and genital aphthous and skin lesions are the historically described triad. ABD uveitis is chronic relapsing and often sight-threatening and, according to the actual guidelines, to limit posterior segment involvement and prevent visual impairment high-dose and long-term systemic anti-inflammatory treatment is indicated. Corticosteroids, both topically and systemically, are the most effective treatment in the acute phase. To overcome the well known side-effects of corticosteroids over the long period, steroid-sparing drugs have been systemically administered showing positive results but having limited safety profile. To potentiate the intraocular pharmacological efficacy of these molecules in refractory ABD uveitis and to circumvent the risks of systemic administration, novel topical and intravitreal formulations and innovative delivering systems have been recently developed.