Actualités sur les modalités thérapeutiques des uvéites

The immunosuppression required for the treatment of uveitis can be achieved through conventional agents or through the use of specific modulators of inflammation. Whatever the choice, it is important to limit side effects: by restricting access to certain drugs in patients presenting a high risk of complications (tuberculosis screening before using Remicade®), reducing side effects through preventive measures (use of alendronates during oral corticotherapy), or choosing a local delivery route (intraocular triamcinolone). Intraocular triamcinolone has certain beneficial characteristics such as high local dosage without systemic effect. However, it can cause a pressure rise in 10% to 20% of patients. It requires certain precautions when given to prevent development of a pseudo-endophthalmitis. Remicade® is a novel synthetic immunosuppressant directed against TNF-α. This chimeric antibody can be useful in the treatment of severe uveitis that is unresponsive to conventional therapy. It is currently being tested in clinical trials in uveitis both in Europe and the USA.