Biologic response modifiers in retinal vasculitis

Abstract

Intraocular inflammation is an important cause of blindness both in the developing and developed world. Corticosteroids play a pivotal role in the treatment of intraocular inflammation. Lately, therapy by immunosuppression has taken the center stage for patients with severe intraocular inflammation. However, the side effects of immunosuppressive drugs are oncogenic, infectious, and hematological. Recently, biologic response modifiers specifically targeting suppression of the immune effector responses have revolutionized the treatment of intraocular inflammation. Anti-tumour necrosis factor agents are etanercept, infliximab, and adalimumab. Newer drugs include certolizumab and golimumab. Infliximab has been found to be superior to corticosteroids in treating retinal vasculitis. Anti-interlenkin therapies include rituximab, daclizumab, anakinra, tocilizumab and secukinumab. Rituximab has been proven to be quite effective. Other biologics used are interferons and abatacept. However, there are several limitations and side effects associated with their use.

Keywords: Uveitis; Immunotherapy; Biologic response modifiers; Retinal vasculitis; Non-infectious uveitis

Core tip: Corticosteroids play a pivotal role in the treatment of intraocular inflammation. Lately, therapy by immunosuppression has taken the center stage for patients with severe intraocular inflammation. However, biologic response modifiers specifically targeting suppression of the immune effector responses have revolutionized the treatment of intraocular inflammation.