First global survey among uveitis experts on the management of immunomodulatory drug therapy during the COVID-19 pandemic
Patients with non-infectious, chronically treated uveitis are certainly among those most seriously affected by the impact of the pandemic, as the health emergency altered the normal management of treatment protocols.
This was also the case for diabetic patients with retinopathy or EMD, as well as for those with degenerative macular diseases, such as AMD.
A specific focus on the problems of patients with non-infectious uveitis is envisaged in the first global survey among uveitis experts:
Evolving consensus for immunomodulatory therapy in non-infectious uveitis during the COVID-19 pandemic
Agrawal R, Testi I, Lee CS COVID-19 IMT Study Group, et al
British Journal of Ophthalmology 2021;105:639-647.
With the definition 'non-infectious uveitis' refers to a heterogeneous group of inflammatory eye diseases, which can severely impair visual function and are sometimes associated with systemic inflammatory diseases. The therapy with immunomodulatory drugs (IMT) is often used as a systemic approach to non-infectious uveitis, and the drugs administered typically include corticosteroids (topical, peribulbar, intravitreal, oral and intravenous), while conventional or biological immunosuppressive agents are used when long-term treatment is required and a 'sparing' approach to steroid agent administration is needed.
In the pandemic phase, the main concern related to IMT is clearly theincreased risk of infectionas these drugs act by limiting the patient's immunological response.
Hence the urgent need to define the Guidelines for the management of IMT in patients with uveitis. The highest consensus among experts was reached regarding not starting IMT in patients with suspected or confirmed COVID-19, and using local rather than systemic corticosteroid therapies in patients at high or very high risk of severe or fatal COVID-19.
Treatment choices must, in parallel, take into account the severity of non-infectious uveitis and the extent to which IMT may be considered necessary to avoid inflammatory events that may jeopardise visual function.
For a complete overview you can read the survey in full through this link
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Dr. Carmelo Chines
Direttore responsabile
English 
Italian