Abstract
Purpose :
Noninfectious uveitis (NIU) often manifests as a persistent relapsing disease that may be challenging to treat. This survey was conducted to evaluate current treatment patterns for chronic and acute NIU among retina specialists and identify unmet needs associated with therapy for NIU and associated macular edema (ME).
Methods :
An anonymized online survey on NIU practice patterns was designed and sent to ophthalmologists throughout the US. Screening questions limited respondents to retina specialists with retina/uveitis fellowship training and intravitreal injection experience. The survey consisted of questions related to respondent’s location and specialty, occurrence of ME in association with NIU, NIU treatment patterns and therapeutic unmet needs. Responses were analyzed using descriptive statistics.
Results :
Survey respondents (N=150) were evenly distributed geographically. Respondents reported ME secondary to 31% and 61% of acute and persistent NIU cases respectively, with an overall rate of 47%. Corticosteroids were the most common initial treatment for acute NIU (>90% of cases), mostly administered topically. Proportions of patients with unilateral/bilateral acute NIU receiving topical corticosteroids were 93%/91%, 51%/47% and 47%/46% for anterior, posterior and pan NIU, respectively. In persistent NIU, therapy was typically changed to another corticosteroid and/or a non-steroidal immunosuppressant. Among patients receiving corticosteroids for persistent NIU, periorbital delivery was the most common route of administration for unilateral/bilateral anterior NIU (59%/55%), while intravitreal delivery was most common for posterior NIU (64%/59%) and pan NIU (68%/63%). Respondents refrained from using corticosteroids in 20% of patients due to concern over elevated intraocular pressure (IOP) and considered elevated IOP, glaucoma and cataract risk to be moderately high concerns when selecting therapy (ranking of 4.0, 3.9, 3.5, respectively, on a 1-5 scale). A lower risk of IOP elevation was ranked as the greatest unmet need for corticosteroid therapies.
Conclusions :
Survey results indicate that ME is commonly associated with NIU, and local corticosteroids are typically used first-line. However, physicians may limit use of corticosteroids due to risk of associated side effects such as cataract and IOP elevation; effective therapies with lower incidence of these adverse reactions are warranted.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.