The Gold Standard of Noninfectious Uveitis: Corticosteroids
The Gold Standard of Noninfectious Uveitis: Corticosteroids
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DOI：
10.1159/000336676
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发表时间：
2012-01-01
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影响因子：
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通讯作者：
LeHoang, Phuc
中科院分区：
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作者：
LeHoang, Phuc
皮质类固醇（CS）被认为是治疗非感染性葡萄膜炎的主要方法。只有在排除了传染源或可能的假面舞会综合征后，才能使用这些药物。不同的CS制剂可用于不同的给药方式：局部、眼周、眼内、全身或上述途径的组合。它们的适应症取决于许多因素，其中包括类型（累及或不累及后段）、严重程度、单侧/双侧、眼内炎症的慢性性。诱导治疗必须是积极的，以便尽快克服眼内炎症，避免永久性组织损伤。然后根据临床反应和最小的静息期后逐渐减少给药方案。在严重不良反应的威胁下，维持CS治疗不应超过6-12个月。在慢性病例中，不能使用高剂量CS单药治疗；当需要长期治疗来控制疾病时，及时添加免疫调节治疗是很重要的。虽然CS是治疗的第一线，但CS的临床反应类型并不是免疫调节有效性的可靠指标：对CS无反应的非感染性葡萄膜炎可能对单独免疫调节或联合CS有反应。巴塞尔S. Karger股份有限公司版权所有
Corticosteroids (CS) are considered to be the mainstay of therapy in noninfectious uveitis. They can be administered only after excluding an infectious origin or a possible masquerade syndrome. Different CS preparations can be used with various modes of administration: topical, periocular, intraocular, systemic or a combination of the above routes. Their indications depend upon numerous factors, among them the type (involving or not the posterior segment), the severity, the uni-/bilaterality, the chronicity of the intraocular inflammation. The induction treatment must be aggressive in order to overcome the intraocular inflammation as rapidly as possible avoiding permanent tissue damage. The dosage regimen is then tapered according to the clinical response and after a minimum period of quiescence. The maintenance CS treatment should not exceed 6-12 months under the threat of severe adverse effects. In chronic cases, high-dosage CS monotherapy cannot be used; it is important to add an immunomodulatory treatment on time when a long-term therapy is needed to control the disease. Although CS represent the first line of treatment, the type of clinical response to CS is not a reliable indicator of the effectiveness of immunomodulation: a noninfectious uveitis unresponsive to CS may respond to immunomodulation alone or combined with CS. Copyright (C) 2012 S. Karger AG, Basel