Treatment of Posterior Uveitis or Panuveitis in Ocular Sarcoidosis
When sarcoidosis involves the posterior segment of the eye — or extends to panuveitis — the clinical picture differs from anterior disease and typically calls for a more aggressive treatment strategy.
Clinical Scenario
This protocol addresses patients with ocular sarcoidosis presenting with posterior uveitis or panuveitis. In these presentations, systemic therapy is usually required rather than local measures alone.
Treatment Approach
Management is built around corticosteroid-based therapy, with systemic agents forming the cornerstone — effective for controlling inflammation both acutely and over time. The specific delivery route and intensity depend on disease severity and how urgently control is needed.
The complete regimen — including sequencing, dosing decisions, and local adjuncts — is in the full protocol.
References
- For posterior uveitis or panuveitis, systemic therapy is usually used.
- Systemic corticosteroids are usually effective in controlling inflammation in both the short and long term.
- For severe disease, the typical initial dosage of prednisone is 20-40 mg/day, while some use as much as 1 mg/kg/day.
- If immediate therapy is needed, intravenous corticosteroids in 1-gram pulses are given.
- However, due the risks of systemic corticosteroids – especially with long-term use – some physicians use periocular injections of corticosteroids in the posterior or sub-Tenon's space, or in the orbital floor.
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