Observational Study in Real Clinical Practice of the Treatment of Non-Infectious Uveitis

Abstract

Background: Uveitis is an ocular disease that is a major cause of morbidity and blindness in the developed world. Although Immunosuppressive drugs and biologic therapy have been shown to be effective in their treatment there are no clear protocols for their use. Objectives: To describe the characteristics of patients with uveitis associated with immunologic or idiopathic disease who require immunosuppressive treatment and their response in real clinical practice. Methods: Observational, descriptive, longitudinal, and retrospective study of a cohort of patients diagnosed with uveitis associated with immunologic or idiopathic diseases attended in a multidisciplinary consultation between January 2011 and February 2022. To assess the response to treatment, we evaluated the change in visual acuity and vitritis and the presence of macular edema. Results: We included 356 patients (mean age at diagnosis 42.8 ± 15.8 years, 50% female). Of the total, 157 (44%) had a single flare and 164 (46%) more than three. The involvement was bilateral in 85 patients (24%) and anterior (73%) and idiopathic (43%) were the most frequent. Twelve percent required treatment with systemic corticosteroids and 66 patients (18.5%) immunosuppressive/biological treatment, methotrexate being the most used (55%). Ten patients of the 66 (15%) started treatment with biologics and 34 (48%) required them at some point during the disease, adalimumab being the most used. Thirty-five patients (53%) needed to change drug due to lack of response. There were no differences between different drugs in the resolution of vitritis and improvement of vision. Disappearance of macular edema was achieved in all patients treated with tocilizumab.