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Abdalla Elsayed MEA, Kozak I. Pharmacologically induced uveitis. Surv Ophthalmol 2021; 66:781-801. [PMID: 33440194 DOI: 10.1016/j.survophthal.2021.01.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 12/31/2020] [Accepted: 01/04/2021] [Indexed: 12/26/2022]
Abstract
Treatments of numerous systemic and local diseases of different etiologies may be accompanied by an unwanted side effect in the form of uveitis. We inform readers about medications that have the potential to cause uveitis and analyze the strength of association of these medications with uveitis. Subsequently, cessation of medication or appropriate treatment can be individualized for each patient for the purpose of preventing further damage to tissue structure and function. Being aware of these associations, physicians may readily identify medications that may cause uveitis and avoid expensive and unnecessary clinical and laboratory testing.
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Affiliation(s)
| | - Igor Kozak
- Moorfields Eye Hospitals UAE, Abu Dhabi, United Arab Emirates.
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Dubicanac M, Radespiel U, Zimmermann E. A review on ocular findings in mouse lemurs: potential links to age and genetic background. Primate Biol 2017; 4:215-228. [PMID: 32110707 PMCID: PMC7041539 DOI: 10.5194/pb-4-215-2017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 09/18/2017] [Indexed: 12/14/2022] Open
Abstract
Mouse lemurs, the world's smallest primates, inhabit forests in
Madagascar. They are nocturnal, arboreal and dependent on vision
for their everyday lives. In the last decades, the grey mouse
lemur became increasingly important for biomedical research, in particular
aging research. Experiments which require the combination of visual
fitness and old age consequently depend on a solid knowledge of
ocular pathologies. Although ocular diseases in mouse lemurs have
been described as being common, they have not received much
attention so far. Yet it is important to know when and why ocular
diseases in captive mouse lemurs may occur. This review aims to
provide a comprehensive overview of known ocular findings in mouse
lemurs. It summarizes the frequency of ocular findings in captive
mouse lemur colonies and points to their likely causes and treatment
options based on the evidence available from other animals and
humans. In addition, it shall be discussed whether age or genetic
background may affect their development. This review may be used as
a reference for future studies which require an assessment of visual
performance in mouse lemurs and help to evaluate observed clinical
signs and ocular diseases. Furthermore, the high incidence of
specific diseases may provide new perspectives and set the groundwork
for a new animal model for ocular research.
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Affiliation(s)
- Marko Dubicanac
- Institute of Zoology, University of Veterinary Medicine Hannover, Buenteweg 17, 30559 Hannover, Germany
| | - Ute Radespiel
- Institute of Zoology, University of Veterinary Medicine Hannover, Buenteweg 17, 30559 Hannover, Germany
| | - Elke Zimmermann
- Institute of Zoology, University of Veterinary Medicine Hannover, Buenteweg 17, 30559 Hannover, Germany
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London NJS, Garg SJ, Moorthy RS, Cunningham ET. Drug-induced uveitis. J Ophthalmic Inflamm Infect 2013; 3:43. [PMID: 23522744 PMCID: PMC3637087 DOI: 10.1186/1869-5760-3-43] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Accepted: 03/13/2013] [Indexed: 01/21/2023] Open
Abstract
A number of medications have been associated with uveitis. This review highlights both well-established and recently reported systemic, topical, intraocular, and vaccine-associated causes of drug-induced uveitis, and assigns a quantitative score to each medication based upon criteria originally described by Naranjo and associates.
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Affiliation(s)
- Nikolas JS London
- Retina Consultants San Diego, 9850 Genesee Avenue, Suite 700, La Jolla, CA, 92037, USA
| | - Sunir J Garg
- MidAtlantic Retina, The Retina Service of Wills Eye Institute, Thomas Jefferson University, 840 Walnut Street, Suite 1020, Philadelphia, PA, 19107, USA
| | - Ramana S Moorthy
- Associated Vitreoretinal and Uveitis Consultants, St. Vincent Hospital and Health Services, Indianapolis, IN, 46260, USA
- Associate Clinical Professor of Ophthalmology, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Emmett T Cunningham
- Department of Ophthalmology, California Pacific Medical Center, San Francisco, CA, 94115, USA
- Department of Ophthalmology, Stanford University School of Medicine, Stanford, CA, 94305-5101, USA
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Intraocular pressure changes: an important determinant of the biocompatibility of intravitreous implants. PLoS One 2011; 6:e28720. [PMID: 22194895 PMCID: PMC3237488 DOI: 10.1371/journal.pone.0028720] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2011] [Accepted: 11/14/2011] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND In recent years, research efforts exploring the possibility of using biomaterial nanoparticles for intravitreous drug delivery has increased significantly. However, little is known about the effect of material properties on intravitreous tissue responses. PRINCIPAL FINDINGS To find the answer, nanoparticles made of hyaluronic acid (HA), poly (l-lactic acid) (PLLA), polystyrene (PS), and Poly N-isopropyl acrylamide (PNIPAM) were tested using intravitreous rabbit implantation model. Shortly after implantation, we found that most of the implants accumulated in the trabecular meshwork area followed by clearance from the vitreous. Interestingly, substantial reduction of intraocular pressure (IOP) was observed in eyes implanted with particles made of PS, PNIPAM and PLLA, but not HA nanoparticles and buffered salt solution control. On the other hand, based on histology, we found that the particle implantation had no influence on cornea, iris and even retina. Surprisingly, substantial CD11b+ inflammatory cells were found to accumulate in the trabecular meshwork area in some animals. In addition, there was a good relationship between recruited CD11b+ cells and IOP reduction. CONCLUSIONS Overall, the results reveal the potential influence of nanoparticle material properties on IOP reduction and inflammatory responses in trabecular meshwork. Such interactions may be critical for the development of future ocular nanodevices with improved safety and perhaps efficacy.
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Abstract
BACKGROUND Much experience has been gained with the use of older classes of antiglaucoma agents--topical beta-adrenergic-receptor antagonists, nonselective adrenergic-receptor agonists, oral carbonic anhydrase inhibitors, and cholinergic agents. In the past decade, new drugs and classes of drugs used to treat glaucoma have become available, including topical carbonic anhydrase inhibitors, prostaglandin analogues, and alpha2-adrenergic-receptor agonists. Extensive community-based use of antiglaucoma medications has led to an increased understanding of the acute and long-term safety and tolerability issues associated with their use. OBJECTIVE This paper reviews the side effects associated with the various classes of topical antiglaucoma drugs, with a particular focus on long-term safety issues.
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Affiliation(s)
- J S Schuman
- New England Eye Center, New England Medical Center, Tufts University School of Medicine, Boston, Massachusetts 02111, USA.
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Abstract
Uveitis has been reported in association with a variety of topical, intraocular, periocular, and systemic medications. To establish causality of adverse events by drugs, in 1981, Naranjo and associates proposed seven criteria, which are related to the frequency and documentation of the event; circumstances of occurrence, recovery, and recurrence; and coexistence of other factors or medications. Rarely does a drug meet all seven criteria. The authors review reports of drug-associated uveitis, applying the seven criteria and examining possible mechanisms. Only systemically administered biphosphonates and, perhaps, topical metipranolol meet all seven criteria. Systemic sulfonamides, rifabutin, and topical glucocorticoids fulfill at least five criteria.
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Affiliation(s)
- R S Moorthy
- Associated Vitreoretinal and Uveitis Consultants, Indianapolis, Indiana, USA
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Abstract
Drug-induced uveitis is a relatively rare occurrence. For example, the patient database at the tertiary referral Uveitis Clinic at the Casey Eye Institute, Oregon Health Sciences University records an incidence of less than 0.5%. Despite this, the frequency of uveitis secondary to rifabutin therapy in AIDS patients has brought greater recognition to the potential role of medications as a cause of intraocular inflammation. A brief review of uveitis including its classification, causes, symptoms and signs is presented along with a review of systemic medications associated with uveitis. These medications include cidofovir, cobalt, diethylcarbamazepine, pamidronic acid (disodium pamidronate), interleukin-3 and interleukin-6, oral contraceptives, quinidine, rifabutin, streptokinase and sulfonamides. Other systemic medications may cause uveitis. Topical ocular medications such as beta-blockers and corticosteroids as well as other topical ocular medications have been associated with uveitis. Cidofovir, pamidronic acid, sulfonamides, rifabutin and topical metipranolol can 'probably' cause uveitis. The remainder of the medications discussed have a 'possible' cause-and-effect relationship with uveitis. Treatment begins with recognition of a drug-related event and usually subsequent avoidance of the drug. Therapy depends on the severity and likelihood of the reaction. Drug-induced uveitis is almost always reversible within weeks of discontinuation of the drug and treatment of the inflammation.
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Affiliation(s)
- F W Fraunfelder
- Department of Ophthalmology, Casey Eye Institute, Oregon Health Sciences University, Portland, USA
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Patel NP, Patel KH, Moster MR, Spaeth GL. Metipranolol-associated nongranulomatous anterior uveitis. Am J Ophthalmol 1997; 123:843-4. [PMID: 9535634 DOI: 10.1016/s0002-9394(14)71139-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE To describe the findings in a patient with a nongranulomatous anterior uveitis, presumed to be induced by metipranolol. METHOD A 69-year-old woman developed bilateral, nongranulomatous, anterior uveitis while undergoing treatment with metipranolol 0.3% for primary open-angle glaucoma. Four months after resolution of the initial episode, the patient was challenged with metipranolol 0.3% in the right eye. RESULT On reinstituting metipranolol 0.3%, the patient once again developed a unilateral, nongranulomatous, anterior uveitis in the challenged eye. CONCLUSION Metipranolol 0.3% eyedrops, used to treat primary open-angle glaucoma, appear to cause a nongranulomatous anterior uveitis.
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Affiliation(s)
- N P Patel
- Glaucoma Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA 19107, USA
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Abstract
PURPOSE Topical metipranolol therapy for primary open-angle glaucoma has been associated with anterior granulomatous uveitis in the United Kingdom. We studied granulomatous uveitis reactions to topical metipranolol 0.3% therapy for primary open-angle glaucoma in two patients in the United States. METHODS Two patients, aged 71 and 81 years, were given topical metipranolol 0.3% therapy for primary open-angle glaucoma. RESULTS Both developed granulomatous uveitis. The iritis was associated with an increase in intraocular pressure in both patients and resolved on discontinuation of the drug. One patient was inadvertently rechallenged with metipranolol, and the iritis recurred. CONCLUSIONS Topical metipranolol 0.3% therapy may be associated with the development of granulomatous uveitis and a paradoxical increase in intraocular pressure.
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Affiliation(s)
- R B Melles
- Department of Ophthalmology, Kaiser Permanente Medical Center, Redwood City, CA 94063
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Akingbehin T, Villada JR. Metipranolol-induced adverse reactions: II. Loss of intraocular pressure control. Eye (Lond) 1992; 6 ( Pt 3):280-3. [PMID: 1359979 DOI: 10.1038/eye.1992.53] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
This paper reviews the behaviour of intraocular pressure (IOP) in glaucomatous eyes treated with metipranolol with and without drug-induced adverse reactions (ADRs). Two hundred and forty seven patients with open angle glaucoma who were receiving the three different strengths of metipranolol (0.1%, 0.3%, and 0.6%) in our Department and the 7 patients who participated in the metipranolol rechallenge trial were included in this study. Out of the 247 patients, there were 52 eyes of 29 patients who showed 78 episodes of ADRs associated with metipranolol. Forty five of these 78 episodes (57.6%) were associated with loss of IOP control. Two of the 7 eyes treated with metipranolol in the rechallenge trial showed loss of IOP control, 1 of them without any signs of ocular inflammation. We further studied all the glaucomatous eyes controlled with metipranolol 0.6% only and 22 eyes were identified with loss of IOP control but without recognisable signs or symptoms of ADR. Five other eyes in this group later developed metipranolol-induced ADRs. The possible pathophysiological mechanisms for the loss of IOP control are discussed and it is suggested that the active drug, metipranolol, could be directly implicated.
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Affiliation(s)
- T Akingbehin
- Department of Ophthalmology, District General Hospital, Southport
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