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Local steroid therapy for posterior uveitis remains the preferred treatment option
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KOLOA, Hawaii — Pattern recognition is crucial to identifying posterior uveitis, and findings from the clinical exam should prompt targeted laboratory testing, according to a speaker here.
 Daniel F. Martin |
However, "laboratory tests are supportive only and do not replace clinical suspicion," Daniel F. Martin, MD, said at Retina 2010.
After infection is excluded as a cause of posterior inflammation, Dr. Martin added, the majority of cases remain idiopathic, but that does not necessarily affect treatment paradigms because diagnosis of systemic autoimmune disease usually has no impact on therapy.
"Steroid or immunosuppressive therapy will be driven by ocular disease," Dr. Martin, who was awarded the Speaker of the Day for Thursday, said.
Treatment of posterior uveitis should start with steroids to help snuff inflammation quickly, even though steroids confer a high risk of glaucomatous changes; undertreatment of uveitis still causes significantly more vision loss than steroid-induced glaucoma and repeat flare-ups have a cumulative effect of visual loss, Dr. Martin said.
A review of published literature on posterior uveitis shows that delivery of therapy directly to the back of the eye is usually more effective than systemic therapy, Dr. Martin said.
Hawaiian Eye and Retina 2011 will be held January 16-21, 2011 at the Hyatt Regency Maui Resort & Spa in Ka'anapali, Maui. Learn more at OSNHawaiianEye.com.