Treatment of Ocular Sarcoidosis in Anterior Uveitis

Anterior uveitis is a recognised ocular manifestation of sarcoidosis requiring prompt, targeted management to suppress intraocular inflammation and prevent vision-threatening complications.

Clinical scenario Anterior uveitis in ocular sarcoidosis — inflammation affecting the front of the eye (iris, ciliary body) in the setting of confirmed sarcoidosis. Local therapy with corticosteroid eye drops is typically the first approach to suppress inflammation; cycloplegic drops help manage pain and reduce the risk of intraocular scarring.

Treatment approach — partial overview When local therapy alone is insufficient, the protocol involves escalation to a systemic cytotoxic agent to provide corticosteroid-sparing control of the disease. Full regimen, agent selection, and sequencing available in the structured protocol below.

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References

Anterior uveitis usually can be managed with local therapy using corticosteroid eye drops to suppress inflammation and cycloplegic eye drops to suppress pain and avoid intraocular scarring.

If greater than 10 mg prednisone is needed to control the disease, then corticosteroid-sparing drugs should be used.

Cytotoxic drugs such as methotrexate, azathioprine, and mycophenolate mofetil have been used with success.

Due to its flexibility, effectiveness and the ability to provide ongoing therapy and treat extraocular aspects of sarcoidosis simultaneously, cytotoxic therapy, usually cytotoxic agents, has been the mainstay of therapy.

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