Tubulointerstitial nephritis and uveitis syndrome (TINU) frequently involves the eye in the form of bilateral, intermediate, or posterior uveitis. These presentations require systemic therapy — and when initial corticosteroid treatment does not promptly resolve ocular inflammation, a structured next-line protocol applies.
The first-line approach for bilateral, intermediate, or posterior uveitis in TINU syndrome is systemic corticosteroids, with local steroid injections reserved for rare unilateral cases. Progression to this protocol is indicated when that treatment fails to achieve prompt resolution of ocular inflammation.
This protocol addresses TINU syndrome presenting with bilateral uveitis, intermediate uveitis, or posterior uveitis in patients whose ocular inflammation has not responded adequately to corticosteroid therapy.
A steroid-sparing immunomodulatory strategy is introduced, with the aim of achieving and sustaining ocular quiescence over an extended period before any withdrawal of treatment is considered. The complete regimen, sequencing, and agent selection are detailed in the full protocol.
Maintenance of ocular quiescence for at least 12–24 months.
DOI: 10.1097/ICU.0b013e3283318f9a
In bilateral, intermediate, or posterior disease, systemic corticosteroids are typically required with the option for local steroid injections reserved for the rare unilateral case.
We institute IMT as required for improved anti-inflammatory control, to reduce recurrences upon steroid tapering, or to reduce unwanted steroid-related adverse effects, and seek to maintain quiescence for at least 12–24 months before withdrawing treatment.
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