Specific clinical scenario
Non-Infective Posterior Uveitis: Treatment When Infective Causes Have Been Ruled Out
This protocol addresses posterior uveitis confirmed to be non-infective — a scenario that requires a different management approach once infectious aetiology has been systematically excluded.
Clinical Scenario
The patient presents with posterior uveitis in which infective causes have been thoroughly evaluated and excluded. Establishing this distinction is essential, as it directly determines the appropriate treatment pathway. Systemic steroids are the mainstay of therapy in non-infective posterior uveitis.
Treatment Approach (Overview)
For cases that prove refractory or develop associated complications, the structured protocol incorporates biological agents as well as targeted local drug delivery strategies — each matched to the specific complication pattern observed.
The complete evidence-based regimen, including step-by-step sequencing and the full range of therapeutic options, is available in the structured protocol below.
References
DOI: 10.4103/0301-4738.58470
- Systemic steroids are the mainstay of therapy in non-infective posterior uveitis.
- Biologicals such as infliximab for the treatment of refractory non-infective posterior uveitis and severe SFU and daclizumab and tacrolimus for the treatment of BCR have been used with favorable response.
- Local drug delivery such as intravitreal triamcinolone for refractory CME is also effective.
- Inflammatory CNVM has been satisfactorily treated with intravitreal triamcinolone, bevacizumab anecortave acetate in serpiginous choroiditis-associated CNVM, and sirolimus for MFC-associated CNVM.
- Fluocinolone acetonide, a local drug delivery implant, has been found to be useful in a large multicentre trial.
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