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Drug-induced uveitis
R S Moorthy1, S Valluri, L M Jampol
1Associated Vitreoretinal and Uveitis Consultants, Indianapolis, Indiana, USA.
Survey of Ophthalmology
|June 23, 1998
Summary
Drug-induced uveitis can occur with various medications. Systemic bisphosphonates and topical metipranolol are strongly linked, meeting all causality criteria, while other drugs fulfill fewer criteria.
Area of Science:
- Ophthalmology
- Pharmacology
- Clinical Toxicology
Background:
- Uveitis is an ocular inflammatory condition linked to numerous medications.
- Establishing drug causality for adverse events is crucial for patient safety.
- The Naranjo criteria (1981) provide a framework for assessing drug causality.
Purpose of the Study:
- To review and assess drug-associated uveitis reports using the Naranjo criteria.
- To identify medications with a high probability of causing uveitis.
- To examine potential mechanisms of drug-induced uveitis.
Main Methods:
- Systematic review of literature on drug-associated uveitis.
- Application of the seven Naranjo criteria to assess causality for each drug.
- Analysis of frequency, documentation, occurrence, recovery, recurrence, and confounding factors.
Main Results:
- Systemically administered bisphosphonates and topical metipranolol met all seven Naranjo criteria for causality.
- Systemic sulfonamides, rifabutin, and topical glucocorticoids met at least five criteria.
- Few drugs meet all criteria, highlighting the complexity of establishing drug-induced uveitis.
Conclusions:
- Bisphosphonates and metipranolol demonstrate a strong causal link to uveitis.
- Several other drug classes show significant association, warranting clinical vigilance.
- Further research into mechanisms of drug-induced uveitis is needed.