Close Coordination of Care
First-line treatment for uveitis typically includes topical or injectable corticosteroids, but the severity of disease and frequency of recurrence will dictate if additional treatments are needed. These treatments may include oral corticosteroids, methotrexate, mycophenolate mofetil and, if necessary, the addition of biologic treatments, such as tumor necrosis factor inhibitors, anti-interleukin 6 agents, calcineurin inhibitors and B cell depleting agents, such as rituximab. Close coordination of care is needed between ophthalmologists and rheumatologists to effectively treat the disease, monitor for medication side effects and long-term adverse effects, and ensure patients feel supported with regard to all manifestations of their systemic disease.
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Even as some patients will experience more significant joint than eye symptoms over the course of their disease, others may have refractory uveitis despite quiescence of their musculoskeletal symptoms, thus communication between providers is imperative. Collaboration between practitioners in ophthalmology and rheumatology is needed now more than ever.6
The future has the potential to be quite bright for these patients, but only if the channels of communication are kept open and rheumatologists and ophthalmologists alike remain clear-eyed about the importance of recognizing and treating uveitis and its underlying causes.
Jason Liebowitz, MD, completed his fellowship in rheumatology at Johns Hopkins University, Baltimore, where he also earned his MD. He is currently in practice with Arthritis, Rheumatic & Back Disease Associates, New Jersey.
- Sharma SM, Jackson D. Uveitis and spondyloarthropathies. Best Pract Res Clin Rheumatol. 2017 Dec;31(6):846–862.
- Crawford CM, Igboeli O. A review of the inflammatory chorioretinopathies: The white dot syndromes. ISRN Inflamm. 2013 Oct 31;2013:783190.
- Sun L, Wu R, Xue Q, et al. Risk factors of uveitis in ankylosing spondylitis: An observational study. Medicine (Baltimore). 2016 Jul;95(28):e4233.
- Juanola X, Loza Santamaria E, Cordero-Coma M, et al. Description and prevalence of spondyloarthritis in patients with anterior uveitis: The SENTINEL interdisciplinary collaborative project. Ophthalmology. 2016 Aug;123(8):1632–1636.
- Haroon M, O’Rourke M, Ramasamy P, et al. A novel evidence-based detection of undiagnosed spondyloarthritis in patients presenting with acute anterior uveitis: the DUET (Dublin Uveitis Evaluation Tool). Ann Rheum Dis. 2015 Nov;74(11):1990–1995.
- Angeles-Han ST, Ringold S, Beukelman T, et al. 2019 American College of Rheumatology/Arthritis Foundation guideline for the screening, monitoring, and treatment of juvenile idiopathic arthritis-associated uveitis. Arthritis Care Res (Hoboken). 2019 Jun;
71(6):703–716. Epub 2019 Apr 25. Simultaneously published by Arthritis Rheumatol. 2019;71:864–877.