Autoimmune uveitis: clinical, pathogenetic, and therapeutic features.

Area of Science:

• Ophthalmology
• Immunology

Background:

• Autoimmune uveitis (AU) is a non-infectious inflammatory condition affecting the eye's vascular layer.
• It can lead to significant visual impairment or blindness if not diagnosed and treated promptly.
• While often idiopathic, AU can be associated with systemic diseases, and its severity varies based on the affected uveal region and influencing factors like genetics.

Purpose of the Study:

• To review the clinical features and pathogenetic mechanisms of autoimmune uveitis (AU).
• To discuss current and emerging therapeutic strategies for managing AU.
• To summarize and critically evaluate recent clinical trials in AU treatment.

Main Methods:

• Literature review of clinical features, pathogenesis, and treatment of autoimmune uveitis (AU).
• Analysis of current therapeutic options, including corticosteroids, immunosuppressants, and biological agents.
• Summary and critical discussion of major clinical trials in AU treatment over the past 12 years.

Main Results:

• AU pathogenesis is complex, involving T-cell mediated immune responses against retinal antigens, with potential B-cell involvement.
• Corticosteroids are first-line therapy, with immunosuppressants for resistant cases. Biological agents targeting TNF-α show significant therapeutic potential.
• A paucity of large randomized clinical trials exists, highlighting the need for standardized treatment regimens.

Conclusions:

• Autoimmune uveitis (AU) management is challenging due to its heterogeneity and limited high-quality trial data.
• Emerging biological therapies offer new hope for improving treatment efficacy and preventing vision loss.
• Further research and standardized clinical trials are crucial for optimizing AU patient care.