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In this prospective case series, the authors assessed the data of 176 patients (284 eyes) with noninfectious uveitis with the aim of determining the change in ongoing immunomodulatory and biologic therapies and the number of uveitis relapses during the COVID-19 pandemic. They found that uveitis specialists may tend to reduce the ongoing systemic immunomodulatory therapies or to prescribe less aggressive treatment.
The authors caution that patients with ocular inflammation are at high risk of relapse due to changes in their therapies. This is a tough situation to be in all around. Many people stopped using ibuprofen at the beginning of the pandemic because of concerns of virus susceptibility. That was for very minor problems. This is a different level with many ramifications, regardless of which you choose.
– Raza M. Shah, MD
This abstract is available on the publisher's site.
To evaluate the change in the ongoing immunomodulatory (IMT) and biological therapies among patients with non-infectious uveitis (NIU), and determine the number of uveitis relapses during the COVID-19 pandemic.
In this national multicentric prospective case series, data of subjects with NIU receiving corticosteroids, systemic IMT and/or biological agents were analysed. The data collection was performed from 1 March 2020 to 25 June 2020. Main outcome measures included change in the ongoing treatments with corticosteroids, IMT and biological agents, use of alternate therapies and rates of uveitis relapse.
In this study, 176 patients (284 eyes) with NIU (mean age: 33±17.1 years; males: 68) were included. A total of 121 eyes (90 patients) were deemed to have active NIU. Of these, seven subjects (7.8%) did not receive intravenous methylprednisolone despite need felt by the treating uveitis experts. In addition, 35 subjects (57.4%) received a rapid tapering dosage of oral corticosteroids despite active disease. A total of 161 (91.5%) subjects were receiving systemic IMT and 25 (14.2%) were on biological therapies. Overall, IMT was altered in 29/161 (18.0%) subjects. Twenty-two eyes were treated with intravitreal therapies in the study period. Fifty-three eyes (32.5%, 29 subjects) developed relapse of NIU, of which 25 subjects (86.2%) were deemed to have reactivation related to altered systemic IMT. No patient developed COVID-19 during follow-up.
During the ongoing COVID-19 pandemic, uveitis specialists may tend to reduce the ongoing systemic IMT, or prefer less aggressive treatment strategies for NIU. These subjects may be at high risk of relapse of uveitis.