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Case study: Systemic beta-blocker suppressed refractive uveitis
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Metoprolol tartrate, a systemic beta-blocker, apparently helped to resolve a noninfectious case of anterior and posterior uveitis that was refractory to steroids and immunosuppresive therapy, according to Israeli researchers.
Shimon Rumelt and colleagues at Nahariya Medical Center reported on their evaluation and treatment of a 49-year-old patient with noninfectious anterior and posterior uveitis. The patient had been treated for 3 years with topical and systemic corticosteroids and systemic cyclosporine A; these treatments did not resolve the uveitis. Uveitic glaucoma developed bilaterally, necessitating the performance of Nd:YAG laser iridotomies and use of antiglaucoma medications.
The patient developed palpitations attributed to idiopathic paroxysmal supraventricular tachycardia and short ventricular tachycardia. Metoprolol tartrate was administered for the palpitations, and the researchers noted that the patient’s uveitis resolved.
Six weeks later the corticosteroids and the cyclosporine A were withdrawn without disease recurrence. A trial discontinuation of metoprolol after 6 months resulted in a flare-up of the disease, and following its readministration the inflammation again resolved. The patient has been taking metoprolol for a year without recurrence, the authors reported.
It is possible that a subgroup of patients with refractory uveitis may respond to drugs other than the traditional anti-inflammatory and immunosuppresive therapies, such as metoprolol, the authors said.
The study is published in the January issue of Eye.