Drug-Induced Uveitis: Patterns, Pathogenesis and Clinical Implications.

Area of Science:

• Ophthalmology
• Pharmacology
• Immunology

Background:

• Drug-induced uveitis is an underdiagnosed cause of ocular inflammation.
• It presents variably, mimicking other ocular conditions.
• An increasing number of systemic and topical drugs are implicated.

Purpose of the Study:

• To review the mechanisms, clinical presentations, and management of drug-induced uveitis.
• To provide a comprehensive evaluation of specific drug classes associated with uveitis.
• To outline diagnostic approaches and emphasize the need for heightened awareness.

Main Methods:

• Systematic review of literature on drug-induced uveitis.
• Analysis of mechanisms including immune-mediated reactions, direct toxicity, and idiosyncratic responses.
• Evaluation of specific drug classes: topical agents, intravitreal therapies, antimicrobials, bisphosphonates, TNF inhibitors, immune checkpoint inhibitors, BRAF/MEK inhibitors, and vaccines.

Main Results:

• Drug-induced uveitis pathogenesis involves diverse mechanisms.
• Clinical presentations vary widely, requiring differentiation from autoimmune/infectious causes.
• Diagnosis relies on high suspicion, drug history, and specific clinical/imaging features.

Conclusions:

• Heightened awareness of drug-induced uveitis is crucial given the expanding list of implicated medications.
• Accurate diagnosis requires pattern recognition, temporal correlation, and structured assessment.
• Understanding pathogenesis aids treatment decisions and pharmacovigilance for novel therapies.