Ramana S Moorthy1,2,3, Meena S Moorthy4, Emmett T Cunningham5,6,7,8. 1. Associated Vitreoretinal and Uveitis Consultants. 2. Department of Ophthalmology, Indiana University Medical Center, Indianapolis. 3. St. Vincent Hospital and Health Services. 4. Indiana University, Bloomington, Indiana. 5. The Department of Ophthalmology, California Pacific Medical Center, San Francisco. 6. The Department of Ophthalmology, Stanford University School of Medicine, Stanford. 7. The Francis I. Proctor Foundation, UCSF School of Medicine. 8. West Coast Retina Medical Group, San Francisco, California, USA.
Abstract
PURPOSE OF REVIEW: Nearly one-half of all uveitis cases seen at tertiary referral centers have no identifiable cause. Many systemic, paraocular, intraocular, topical medications, and even vaccines can induce intraocular inflammation, scleritis, and rarely orbititis and are often overlooked as causes of uveitis. This review was undertaken to elucidate the strength of association of these medications with uveitis and to make clinicians aware of these associations, especially among newer medications. RECENT FINDINGS: Medication-induced uveitis has become particularly important and more frequently seen because of the advent of biologic therapies such as immune checkpoint inhibitors (ICPIs), BRAF, and MEK inhibitors, antivascular endothelial growth factor agents, and antitumor necrosis factor agents, as well as newer systemic bisphosphonates are strongly associated with uveitis. SUMMARY: The ever-broadening scope of pharmaceuticals now available to treat previously untreatable conditions, such as advanced metastatic cutaneous melanoma, have resulted in unintended ocular inflammatory diseases. Ophthalmologists must recognize that drugs such as ICPIs, BRAF, and MEK inhibitors, anti-vascular endothelial growth factor agents, tumor necrosis factor-α inhibitors, cidofovir, bisphosphonates, topical prostaglandin analogues, topical brimonidine, BCG vaccination can cause of uveitis. Utilizing a thorough review of systems, physicians may readily identify medications that may cause uveitis and avoid expensive and unnecessary laboratory testing.
PURPOSE OF REVIEW: Nearly one-half of all uveitis cases seen at tertiary referral centers have no identifiable cause. Many systemic, paraocular, intraocular, topical medications, and even vaccines can induce intraocular inflammation, scleritis, and rarely orbititis and are often overlooked as causes of uveitis. This review was undertaken to elucidate the strength of association of these medications with uveitis and to make clinicians aware of these associations, especially among newer medications. RECENT FINDINGS: Medication-induced uveitis has become particularly important and more frequently seen because of the advent of biologic therapies such as immune checkpoint inhibitors (ICPIs), BRAF, and MEK inhibitors, antivascular endothelial growth factor agents, and antitumor necrosis factor agents, as well as newer systemic bisphosphonates are strongly associated with uveitis. SUMMARY: The ever-broadening scope of pharmaceuticals now available to treat previously untreatable conditions, such as advanced metastatic cutaneous melanoma, have resulted in unintended ocular inflammatory diseases. Ophthalmologists must recognize that drugs such as ICPIs, BRAF, and MEK inhibitors, anti-vascular endothelial growth factor agents, tumornecrosis factor-α inhibitors, cidofovir, bisphosphonates, topical prostaglandin analogues, topical brimonidine, BCG vaccination can cause of uveitis. Utilizing a thorough review of systems, physicians may readily identify medications that may cause uveitis and avoid expensive and unnecessary laboratory testing.
Authors: K Kiran Kumar; U C Sampritha; Akshata A Prakash; Karishma Adappa; S Chandraprabha; T G Neeraja; N S Guru Prasad; Jessica Basumatary; Suresh Babu Gangasagara; B L Sujatha Rathod; Chakravarthy Raghunathan Jayanthi Journal: Indian J Ophthalmol Date: 2021-03 Impact factor: 1.848
Authors: Raymond L M Wong; Daniel S W Ting; Kelvin H Wan; Kenny H W Lai; Chung-Nga Ko; Paisan Ruamviboonsuk; Suber S Huang; Dennis S C Lam; Clement C Y Tham Journal: Asia Pac J Ophthalmol (Phila) Date: 2020 Jul-Aug