Medicines for the Treatment of Uveitis

Definition

In the medical field, he defines himself uveitis any inflammation involving the uveal tract, consisting of the iris, choroid and ciliary body. To avoid complications, "uveitis" must be treated promptly: just think that 10-15% of affected subjects go blind. The patients most at risk are men and women between the ages of 25 and 50.

Causes

Exogenous uveitis is the immediate expression of surgery, corneal ulcers, perforating wounds or viral / bacterial / fungal infections. The endogenous variant of uveitis (which constitutes the vast majority of eye diseases) appears to be caused by toxoplasma infections, a disease Behçet's, rheumatic pathologies, Fuchs syndrome; however, it should be noted that about 50% of endogenous uveitis does not recognize any precise cause.

Symptoms

The signs that distinguish uveitis can be summarized as: alteration / blurring of vision, eye pain, hypersensitivity to light, red eyes, perception of spots in front of the eyes, presence of white dots in the iris. Symptoms may appear suddenly or gradually, depending on the triggering agent, and may involve only one eye or both.

Complications: Blindness, cataracts (clouding of the lens), optic nerve damage, retinal detachment, glaucoma

The information on Uveitis - Uveitis Cure Drugs is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Uveitis - Uveitis Cure Drugs.

Medicines

Treatment of uveitis focuses on both reducing inflammation and decreasing symptoms; There is no particular prevention to escape from uveitis, other than to protect oneself from sexually transmitted diseases - such as HIV and syphilis - which could predispose the patient to uveitis.
To reduce inflammation, the most used drugs are corticosteroids, to be taken topically (in the form of eye drops) and / or systemically (oral or intravenous administration); some particularly aggressive forms of uveitis require topical injection ( into the eye) of steroid drugs (the injection should clearly be given by experienced healthcare professionals). In some patients, steroid therapy does not immediately exert the desired therapeutic effect; in severe cases, it is conceivable to implant a special device in the eye capable of slowly - but continuously - releasing the right amount of drug. The therapy is usually long: it can last for 24-30 months.
In addition to corticosteroids, mydriatic and cycloplegic drugs are used in therapy for mild to moderate uveitis.
When uveitis is caused by bacterial or protozoal infections (often caused by Toxoplasma gondii), antibiotics and antimalarials are the therapy of choice, even in the absence of corticosteroids. The same goes for viral infections: viral uveitis can be easily treated with special antiviral medicines.
In case of severity, when uveitis does not respond to corticosteroid treatment, therapy with immunosuppressive drugs is conceivable: this therapeutic approach is generally reserved for patients who show a high risk of blindness.
In cases where the eye is heavily compromised, surgery is the last possible option to save sight: vitrectomy removes the gelatinous material that has accumulated in the eye (vitreous).

The following are the classes of drugs most used in the treatment against uveitis, and some examples of pharmacological specialties; it is up to the doctor to choose the most suitable active ingredient and dosage for the patient, based on the severity of the disease, the state of health of the patient and his response to treatment:

Steroids to reduce the inflammation associated with uveitis of unknown etiology

Dexamethasone (eg. Decadron, soldesam, Luxazone 0.2%, Visumetazone COLL. 3ML 0.1%, Luxazone UNG. OFT. 3G 0.2%): in the form of eye drops, apply the product 4-6 times a day, or every 30-60 minutes in case of severe infection. Continue therapy until symptoms reduce. In the form of a cream, apply the product 3-4 times a day. Consult your doctor.
For non-infectious forms of uveitis affecting the posterior segment of the eye, it is possible to use this drug in an alternative way: 1 implant (with 0.7 mg of dexamethasone) can be surgically injected into the vitreous cavity of the involved eye. in uveitis.
Cortisone (eg. Cortis Acet, Cortone): when the topical application of corticosteroids is not sufficient to completely cure uveitis, it is possible to take them by mouth or intramuscularly: it is recommended to take 25-300 mg of the drug per day (based on the severity of symptoms), dividing the load into two daily doses.
Triamcinolone (eg Kenacort, Triamvirgi, Nasacort): indicated to treat uveitis that does not respond effectively to standard treatment with topical corticosteroids. The drug is administered intravitreally, at a dose of 4 mg (100 microlitres of 40 mg / ml suspension or 50 microlitres of 80 mg / ml suspension)
Rimexolone (eg. Vexol, eye drops): it is recommended to instill the drug in the eye, in the form of eye drops, at a dose of 1-2 drops during the day, in the first week; proceed, in the second week of therapy, instilling 1 drop every 2 hours, throughout the day Proceed according to patient response to treatment.

Other drugs and combinations of corticosteroid drugs used in therapy for the treatment of uveitis:

prednisolone / sulfacetamide sodium (e.g. Blephamide)
loteprednol / tobramycin (eg Zylet)

Antibiotics for the treatment of uveitis dependent on bacterial insults (monotherapy)

Sulfasalazine (eg Salazopyrin EN): is a drug belonging to the class of aminosilicate antibiotics. For recurrent acute anterior uveitis, it is recommended to start therapy with a drug dose of 500 mg, to be gradually increased every week. The maintenance dose involves taking 1 gram of active, twice a day, for one year. Do not exceed 3 grams per day.

Combined drugs: cortisone + antibiotics: to accelerate the healing time, many antibiotics are combined with corticosteroids, prepared in eye drops or ointments to be applied directly into the conjunctival sac, involved in uveitis.

Hydrocortisone associated with neomycin and polymyxin B (eg Mixotone): this is a drug combination consisting of a steroid drug (hydrocortisone) and 2 active antibiotic ingredients. This drug fully exerts its therapeutic activity when applied topically. In the form of eye drops, instill 1-2 drops of product in the conjunctival sac of the affected eye (or both), every 3-4 hours, to reduce bacterial infection and, at the same time, exert a powerful anti-inflammatory effect. Increase the frequency of administration in case of severity. These three drugs can also be formulated with bacitracin, a high antibiotic drug.
Dexamethasone + tobramycin (eg TobraDex): this formulation also consists of a steroid (dexamethasone) and an antibiotic. In the form of an ointment, apply a small amount in the lower conjunctival sac, 3-4 times a day. In the form of an ophthalmic suspension, instill 1-2 drops into the lower conjunctival sac every 4-6 hours; it is possible to increase the frequency of administration in case of severe uveitis (every two hours for the first 2 days of therapy).
Gentamicin / prednisolone (eg Pre-G): for the treatment of bacterial uveitis, it is recommended to instill a drop of product in the conjunctival sac of the affected eye, 2-4 times a day. The drug is also available in the form of an ointment to be applied in the eye 1-3 times a day.

Mydriatic drugs: these drugs have the ability to dilate the pupil, indicated to treat inflammation and infections of the eyes, in order to prevent the formation of posterior synechiae.

Cyclopentolateo (eg Ciclolux 1% COLL): muscarinic antagonist drug used in the treatment of uveitis. Instill one or two drops in the affected eye. Repeat every 5-10 minutes, as needed.
Omatropine (eg Omatropina LUX 1% COLL): this is a short-acting muscarinic antagonist, indicated for the treatment of anterior uveitis. Instill 1-2 drops in the eye affected by uveitis, every 3-4 hours. The tear sac should be compressed with the fingers for a few minutes after applying the eye drops.
Atropine (eg. Atropina LUX, Atropi S FN coll, Atropi S FN ophthalmic ointment): in the form of ointment, apply 0.3-0.5 cm of product in the conjunctival sac of the eye affected by uveitis, 1-3 times a day. Atropine is also available as a solution to be instilled in the eye: the indicative dosage is to apply 1-2 drops of the drug in the affected eye, 4 times a day.

Immunosuppressive drugs: Patients who do not respond to the therapies listed above for the treatment of uveitis will need to use drugs that suppress the immune system:

Methotrexate or methotrexate (eg Methotrexate): indicated for severe forms of uveitis, resistant to steroids. For the posology: consult your doctor.
Azathioprine (eg. Azathiopirine, Immunoprin): for the treatment of choroidal neovascularization, it is recommended to take the drug at a dose of 1-1.5 mg / kg per day, in combination with prednisolone or cyclosporine.
Mycoflenate mofetil (eg Mycoflenate mofetil teva): drug of second choice for the treatment of uveitis, to be used when even azathioprine does not fully exert its therapeutic effect. Take approximately 1 gram of the drug, twice a day. Do not exceed 4 g per day.
Etanercept (eg. Enbrel): indicated for the treatment of severe uveitis in affected children, older than 3 years. It is recommended to administer the drug at a dose of 0.4mg / kg per dose, up to a maximum of 25mg The product should be administered subcutaneously, twice a week.
Adalimumab (eg. Humira): injected under the skin, the drug is a powerful anti-inflammatory, to be used as a second choice for the treatment of refractory autoimmune uveitis or associated with idiopathic arthritis. Indicatively, the dosage suggests administering 40 mg of active ingredient each 15 days, up to one year.
Infliximab (e.g. remicade) intravenously, it is recommended to administer the drug at a dose of 5 mg / kg, as a single i.v. infusion. weekly. Repeat administration after 2 and 6 weeks. Proceed with an injection every 2 months.

For glaucoma-dependent forms of uveitis, Toxoplasma gondii and autoimmune diseases, it is necessary to proceed with the treatment of the underlying disease: the healing of the cause also causes the removal of the uveitis.

To learn more read the following articles: