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Standardization of Uveitis Nomenclature Criteria 2021
- Anterior uveitis with our without intermediate/posterior involvement
- Anterior chamber cell
- If vitritis, choroiditis or retinal vasculitis anterior chamber inflammation is also present
- Tubulointerstitial nephritis
- Biopsy proven -OR-
- Elevated urine β-2 microglobulin -AND-
- Abnormal urinalysis or elevated creatinine
- Positive Syphilis serology
- Evidence of Sarcoidosis
- bilateral hilar adenopathy -OR-
- tissue biopsy with non-caseating granulomata
- Up to 32% in those with sudden onset bilateral anterior uveitis
- In those with biopsy proven tubulointerstitial nephritis, 46% had uveitis but 84% if they were screened at the outset, then 3 and 6 months later.(3)
- 88% have a chronic course with frequent relapses
- Active disease can last > 2 years
- 50% recurrence in some studies upon cessation of steroids
- Topical and oral steroids is the most common treatment.(3)
- Prednisone 2 mg/kg/day to start given BID max dose of 60 mg
- Tapering dose depends on kidney function testing
- Given frequent long term need for steroids consider steroid sparing agents when possible
- The following have been used in various studies
- methotrexate (may accumulate in the kidneys and cause toxicity)
- mycofphenolate mofetil
- azathioprine
- TNFα inhibitors
- adalimumab
- infliximab
- golimumab
- tocilizumab