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DOI: 10.1055/a-1111-9490
Intermediäre Uveitis bei Erwachsenen und Kindern – Update
Intermediate Uveitis in Adults and Children – UpdatePublication History
eingereicht 23 December 2019
akzeptiert 24 January 2020
Publication Date:
09 April 2020 (online)
Zusammenfassung
Im Vergleich zu Volkserkrankungen ist die intermediäre Uveitis eine seltene Entität. Ein Ausschluss assoziierter Erkrankungen (in Mitteleuropa vorwiegend in Form einer Sarkoidose oder multiplen Sklerose) sollte bereits bei Erstmanifestation erfolgen. Eine Therapie ist bei Auftreten ausgeprägter Entzündungsaktivität oder visusmindernder Komplikationen indiziert und umfasst primär systemische oder lokale Kortikosteroide sowie ggf. im weiteren Verlauf eine steroidsparende systemische Therapie mit DMARDs (disease-modifying antirheumatic drugs).
Abstract
Intermediate uveitis is a rare disease. Interdiscliplinary investigations to identify or exclude an associated systemic disease (in Central Europe, this would primarily mean sarcoidosis and multiple sclerosis) should be initiated even at the first manifestation of disease. Therapy should be started in those patients with marked inflammatory activity or secondary complications and primarily encompasses local and systemic corticosteroids, although some patients need second line steroid sparing systemic DMARD therapy (DMARD: disease-modifying antirheumatic drug).
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Literatur
- 1 Thorne JE, Suhler E, Skup M. et al. Prevalence of noninfectious uveitis in the United States: a claims-based analysis. JAMA Ophthalmol 2016; 134: 1237-1245 doi:10.1001/jamaophthalmol.2016.3229
- 2 Miserocchi E, Fogliato G, Modorati G. et al. Review on the worldwide epidemiology of uveitis. Eur J Ophthalmol 2013; 23: 705-717 doi:10.5301/ejo.5000278
- 3 Nagpal A, Leigh JF, Acharya NR. Epidemiology of uveitis in children. Int Ophthalmol Clin 2008; 48: 1-7 doi:10.1097/IIO.0b013e31817d740e
- 4 Niederer RL, Sharief L, Bar A. et al. Predictors of long-term visual outcome in intermediate uveitis. Ophthalmology 2017; 124: 393-398 doi:10.1016/j.ophtha.2016.11.013
- 5 Heinz C, Schoonbrood S, Heiligenhaus A. Intermediate uveitis in children and young adults: differences in clinical course, associations and visual outcome. Br J Ophthalmol 2014; 98: 1107-1111 doi:10.1136/bjophthalmol-2013-304589
- 6 Mackensen F, Baydoun L, Garweg J. et al. Leitlinie des Berufsverbands der Augenärzte Deutschlands e. V. und der Deutschen Ophthalmologischen Gesellschaft: Leitlinie Nr. 24a: Uveitis intermedia (Stand: Juli 2014). Klin Monatsbl Augenheilkd 2015; 232: 79-84 doi:10.1055/s-0034-1383197
- 7 Petrushkin H, Kidd D, Pavesio C. Intermediate uveitis and multiple sclerosis: to scan or not to scan. Br J Ophthalmol 2015; 99: 1591-1593 doi:10.1136/bjophthalmol-2015-307269
- 8 Antonazzo IC, Raschi E, Vignatelli L. et al. Occurrence of multiple sclerosis after drug exposure: insights from evidence mapping. Drug Saf 2017; 40: 823-834 doi:10.1007/s40264-017-0551-0
- 9 Daas L, Seitz B, Pleyer U. [Fuchs uveitis]. Ophthalmologe 2017; 114: 481-492 doi:10.1007/s00347-017-0494-y
- 10 Pichi F, Srivastava SK, Nucci P. et al. Peripheral retinoschisis in intermediate uveitis. Retina 2017; 37: 2167-2174 doi:10.1097/IAE.0000000000001463
- 11 Antcliff RJ, Stanford MR, Chauhan DS. et al. Comparison between optical coherence tomography and fundus fluorescein angiography for the detection of cystoid macular edema in patients with uveitis. Ophthalmology 2000; 107: 593-599 doi:10.1016/s0161-6420(99)00087-1
- 12 Tsui I, Kaines A, Schwartz S. Patterns of periphlebitis in intermediate uveitis using ultra wide field fluorescein angiography. Semin Ophthalmol 2009; 24: 29-33 doi:10.1080/08820530802520186
- 13 Kaines A, Tsui I, Sarraf D. et al. The use of ultra wide field fluorescein angiography in evaluation and management of uveitis. Semin Ophthalmol 2009; 24: 19-24 doi:10.1080/08820530802520095
- 14 Thomas AS, Redd T, Campbell JP. et al. The impact and implication of peripheral vascular leakage on ultra-widefield fluorescein angiography in uveitis. Ocul Immunol Inflamm 2019; 27: 349-355 doi:10.1080/09273948.2017.1367406
- 15 Leder HA, Campbell JP, Sepah YJ. et al. Ultra-wide-field retinal imaging in the management of non-infectious retinal vasculitis. J Ophthalmic Inflamm Infect 2013; 3: 30 doi:10.1186/1869-5760-3-30
- 16 Tian M, Tappeiner C, Zinkernagel MS. et al. Evaluation of vascular changes in intermediate uveitis and retinal vasculitis using swept-source wide-field optical coherence tomography angiography. Br J Ophthalmol 2019; 103: 1289-1295 doi:10.1136/bjophthalmol-2018-313078
- 17 Wintergerst MWM, Pfau M, Müller PL. et al. Optical coherence tomography angiography in intermediate uveitis. Am J Ophthalmol 2018; 194: 35-45 doi:10.1016/j.ajo.2018.06.023
- 18 Cerquaglia A, Iaccheri B, Fiore T. et al. New insights on ocular sarcoidosis: an optical coherence tomography angiography study. Ocul Immunol Inflamm 2019; 27: 1057-1066 doi:10.1080/09273948.2018.1497665
- 19 Abucham-Neto JZ, Torricelli AAM, Lui ACF. et al. Comparison between optical coherence tomography angiography and fluorescein angiography findings in retinal vasculitis. Int J Retina Vitreous 2018; 4: 15 doi:10.1186/s40942-018-0117-z
- 20 Chirikov VV, Shah R, Kwon Y. et al. Oral corticosteroid exposure and increased risk of related complications in patients with noninfectious intermediate, posterior, or panuveitis: real-world data analysis. Ophthalmic Epidemiol 2019; 26: 27-46 doi:10.1080/09286586.2018.1513042
- 21 Heiligenhaus A, Bertram B, Heinz C. et al. Stellungnahme der Deutschen Ophthalmologischen Gesellschaft, der Retinologischen Gesellschaft und des Berufsverbandes der Augenärzte Deutschlands zur intravitrealen Therapie des Makulaödems bei Uveitis (Stand: 02.07.2014). Klin Monatsbl Augenheilkd 2014; 231: 929-936 doi:10.1055/s-0034-1382893
- 22 Jaffe GJ, Foster CS, Pavesio CE. et al. Effect of an injectable fluocinolone acetonide insert on recurrence rates in chronic noninfectious uveitis affecting the posterior segment: twelve-month results. Ophthalmology 2019; 126: 601-610 doi:10.1016/j.ophtha.2018.10.033
- 23 Rathinam SR, Babu M, Thundikandy R. et al. A randomized clinical trial comparing methotrexate and mycophenolate mofetil for noninfectious uveitis. Ophthalmology 2014; 121: 1863-1870 doi:10.1016/j.ophtha.2014.04.023
- 24 Rathinam SR, Gonzales JA, Thundikandy R. et al. Effect of corticosteroid-sparing treatment with mycophenolate mofetil vs. methotrexate on inflammation in patients with uveitis: a randomized clinical trial. JAMA 2019; 322: 936-945 doi:10.1001/jama.2019.12618
- 25 Deuter CME, Engelmann K, Heiligenhaus A. et al. Enteric-coated mycophenolate sodium in the treatment of non-infectious intermediate uveitis: results of a prospective, controlled, randomised, open-label, early terminated multicentre trial. Br J Ophthalmol 2018; 102: 647-653 doi:10.1136/bjophthalmol-2017-310156
- 26 Doycheva D, Zierhut M, Blumenstock G. et al. Mycophenolate sodium for the treatment of chronic non-infectious uveitis of childhood. Br J Ophthalmol 2016; 100: 1071-1075 doi:10.1136/bjophthalmol-2015-306701
- 27 Heiligenhaus A, Minden K, Tappeiner C. et al. Update of the evidence based, interdisciplinary guideline for anti-inflammatory treatment of uveitis associated with juvenile idiopathic arthritis. Semin Arthritis Rheum 2019; 49: 43-55 doi:10.1016/j.semarthrit.2018.11.004
- 28 Jaffe GJ, Dick AD, Brezin AP. et al. Adalimumab in patients with active noninfectious uveitis. N Engl J Med 2016; 375: 932-943 doi:10.1056/NEJMoa1509852
- 29 Deutsche Ophthalmologische Gesellschaft, Berufsverband der Augenärzte Deutschlands e. V.. Leitlinie Nr. 24b der DOG und BVA. Ophthalmologe 2017; 114: 1122-1134 doi:10.1007/s00347-017-0582-z
- 30 Suhler EB, Adán A, Brézin AP. et al. Safety and efficacy of adalimumab in patients with noninfectious uveitis in an ongoing open-label study: VISUAL III. Ophthalmology 2018; 125: 1075-1087 doi:10.1016/j.ophtha.2017.12.039
- 31 Sheppard J, Joshi A, Betts KA. et al. Effect of adalimumab on visual functioning in patients with noninfectious intermediate uveitis, posterior uveitis, and panuveitis in the VISUAL-1 and VISUAL-2 Trials. JAMA Ophthalmol 2017; 135: 511-518 doi:10.1001/jamaophthalmol.2017.0603
- 32 Moots RJ, Xavier RM, Mok CC. et al. The impact of anti-drug antibodies on drug concentrations and clinical outcomes in rheumatoid arthritis patients treated with adalimumab, etanercept, or infliximab: results from a multinational, real-world clinical practice, non-interventional study. PLoS One 2017; 12: e0175207 doi:10.1371/journal.pone.0175207
- 33 Leinonen ST, Aalto K, Kotaniemi KM. et al. Anti-adalimumab antibodies in juvenile idiopathic arthritis-related uveitis. Clin Exp Rheumatol 2017; 35: 1043-1046
- 34 Zhao S, Chadwick L, Mysler E. et al. Review of biosimilar trials and data on adalimumab in rheumatoid arthritis. Curr Rheumatol Rep 2018; 20: 57 doi:10.1007/s11926-018-0769-6
- 35 Renton WD, Leveret H, Guly C. et al. Same but different? A thematic analysis on adalimumab biosimilar switching among patients with juvenile idiopathic arthritis. Pediatr Rheumatol Online J 2019; 17: 67 doi:10.1186/s12969-019-0366-x