For doctors, trying to pinpoint the specific cause of uveitis can be challenging. In fact, nearly one-half of uveitis cases in tertiary referral centers have no identifiable cause.
With an ever-expanding array of drugs coming available on the market, a recent review in Current Opinion in Ophthalmology suggests eye care practitioners should consider whether their patients’ meds are the root cause for their uveitis and other ocular complications.
“The ever-broadening scope of pharmaceuticals now available to treat previously untreatable conditions, such as advanced metastatic cutaneous melanoma, have resulted in unintended ocular inflammatory diseases,” the authors state.
Many systemic, paraocular, intraocular and topical medications—and even vaccines—can induce intraocular inflammation, scleritis and in some rare cases, orbititis, and are often overlooked as a cause of uveitis, the study notes. Researchers stress medication-induced uveitis has become particularly important and more frequently seen due to new biologic therapies and drugs such as checkpoint inhibitors, BRAF and MEK inhibitors, anti-vascular endothelial growth factor agents, tumor necrosis factor-α inhibitors, cidofovir, bisphosphonates, topical prostaglandin analogs, topical brimonidine and BCG vaccines.
After performing a thorough review of systems, "physicians may readily identify medications that may cause uveitis and avoid expensive and unnecessary laboratory testing,” the authors say.
|Moorthy RS, Moorthy MS, Cunningham ET Jr. Drug-induced uveitis. Curr Opin Ophthalmol. 2018, Sept. 14 (E-pub, ahead of print).|