MODERN OPPORTUNITIES IN UVEITIS TREATMENT

Abstract

Uveitis is a heterogeneous group of inflammatory diseases of the choroid and adjacent structures. The pathophysiology of uveitis may be different. The treatment approach of infectious and non-infectious uveitis or masquerade syndrome is also different, but the correction of immune disorders of any uveitis should play a leading role. Infectious etiology requires the pathogen eradication with adequate antimicrobial therapy. Therapy of noninfectious uveitis based on the suppression of the local immune response. Depending on the activit y of the inflammatory process it may require system or topical anti-inflammatory and/or immunosuppressive treatment with corticosteroids or immunomodulatory therapeutic agents. The main groups of drugs are presented with the immunosuppressive alkylating agents, corticosteroids, antimetabolites, T-cell inhibitors and biological modulators of the immune response. They can reduce the amount and intensit y of recurrence, the number of complications, decrease the dose of corticosteroids or even replace them in the case of the development of side effects and resistance. An alternative uveitis treatment is extracorporal efferent-quantum hemocorrection methods. The most commonly used is plasmapheresis based on the removal of plasma with dissolved mediators of inflammation, immune complexes, antibodies, exoand endotoxins. Treatment should be pathogenetically oriented and localized to the affected tissue in order to maximize the ratio of efficacy / side effect. Often, however, this can’t be achieved. So the search continues to develop new therapies for use in uveitis that aim to suppress inflammatory activit y, prevent accumulation of damage, and preserve visual function for patients with the minimum possible side effects.