Retinal, vitreous and macular disordersNonsteroidal drugs for the treatment of noninfectious posterior and intermediate uveitisImrie, Fraser R; Dick, Andrew D Author Information Academic Unit of Ophthalmology, University of Bristol and Bristol Eye Hospital, Lower Maudlin Street, Bristol, UK Correspondence to Andrew D. Dick, Academic Unit of Ophthalmology, University of Bristol and Bristol Eye Hospital, Lower Maudlin Street, Bristol, BS1 2LX, UK Tel: +44 117 928 4949; fax: +44 117 925 1421; e-mail: [email protected] Current Opinion in Ophthalmology: May 2007 - Volume 18 - Issue 3 - p 212-219 doi: 10.1097/ICU.0b013e3281107fef Buy Metrics Abstract Purpose of review This review summarizes current nonsteroidal drug therapies for noninfectious posterior and intermediate uveitis. Recent findings Continuing evidence shows that second-line agents including antimetabolites, T-cell inhibitors and alkylating agents, are effective in many patients, allowing reduction in steroid dose and preservation of visual function. There is an increased use of mycophenolate mofetil. Biologic therapies, including the antitumour necrosis factor-α agents and interferons, have demonstrated a high degree of efficacy in controlling uveitis refractory to immunosuppressants. Summary There are an increasing number of treatment options. As the vast majority of published studies in uveitis are case series or nonrandomized trials, there remains a lack of level 1 evidence to guide the choice and duration of therapy. Standard initial treatment for steroid-resistant disease is to add a single immunosuppressant to the regime, with additional agents being substituted or added as required. Combination of two immunosuppressants in addition to steroids may be indicated especially in chronic uveitis. High cost and limited long-term experience with biologic agents have restricted their use to uveitis refractory to immunosuppressants, but evidence suggests a potential therapeutic role earlier in Bechet's disease. © 2007 Lippincott Williams & Wilkins, Inc.