Non-Uveitis Specialists Survey on the Knowledge of Immunosuppressive Agents for Uveitis

Abstract

 

Purpose:

 

Uveitis is an inflammatory disorder of the iris, ciliary body and choroid that can cause significant visual disability and require aggressive immunomodulatory therapy. Insufficient knowledge among physicians and an underestimation of the burden and consequences of uveitis remain a potential barrier to progress in preventing blindness due to uveitis. Thus, we carried out this survey to analyze the knowledge of non-uveitis specialist ophthalmologists, regarding their knowledge on the indications, safety and role of IMT in uveitis.

 

Methods:

 

Forty-one ophthalmologists practicing in New York were presented with a 13-question re-survey. Survey questions were aimed at discerning the perceptions and knowledge regarding immunosuppressive therapy as an example of current standard of care. Participation in the survey was voluntary and the identity of the participants was kept anonymous.

 

Results:

 

Forty-one practicing ophthalmologists re-surveyed from greater New York saw on average 14.7 uveitis patients over a 3-month period and referred 17.1 uveitis patients to a specialist per year. Steroid unresponsiveness was quoted as the main indication for immunosuppressive therapy (68.3%). About 12% were not sure of the indications and the average level of confidence regarding the indication of these agents was 2.8 out of 5. Myelosuppression (22.4%) and immunosuppression (26.9%) were the most common concern for toxicity and side effects of immunomodulatory therapy with an average level of confidence of 2.1 out of 5.

 

Conclusions:

 

There still exist some ophthalmologists in the community, despite clinical trials, evidence in literature, and world expert opinions, that are not aware that IMT therapy constitutes standard of care in cases of severe uveitis unresponsive or intolerable to steroids.  

 

 

Keywords: immunomodulation/immunoregulation