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Effects of Treatment Medications on Patients with Uveitis

Effects of Treatment Medications on Patients with Uveitis. By Alec Rudin. Uveitis. Autoimmune disease affecting the eye Complications include cataracts and vision loss Treated with steroids. The Eye. The Eye Video. Purpose. To research the benefits and risks of treatment medications

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Effects of Treatment Medications on Patients with Uveitis

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  1. Effects of Treatment Medications on Patients with Uveitis By Alec Rudin

  2. Uveitis • Autoimmune disease affecting the eye • Complications include cataracts and vision loss • Treated with steroids

  3. The Eye

  4. The Eye Video

  5. Purpose • To research the benefits and risks of treatment medications • There are different types of treatment because of the diverse set of complications • Set out to find the most effective single or combination

  6. Types of Medications • Ocular Steroids • Used to suppress inflammation at the point of inflammation, but can lead to problems down the road • Antimetabolites • Slows down metabolism, which in turn slows immune system • Biological Agents • The ones noted in the study work to prevent activation of certain immune cells • Corticosteroids P.O. • Technically the same as the ocular form although this is ingested by the body

  7. Hypothesis • It was hypothesized that antimetabolites, combined with the use of ocular steroids, create the most adverse ocular events. • Adverse Ocular Events • Cataract development • Loss in Visual Acuity • Extremely high or low ocular pressure • High levels of ocular inflammation and anterior chamber flare

  8. Method • Retrospective chart review • Visits were taken down from June 2007-July 2009 • Information taken down includes: • Types of medications • Dosage • Levels of inflammation or flare • Ocular pressure measurement • Visual acuity measurement

  9. Results • Number of patients on each treatment

  10. Results: Medications • Number of patients on high dose and low dose medications

  11. Results: Visual Acuity • Number of patients whose visual acuity improved, worsened, or did not change

  12. Results: Ocular Inflammation • Tracking the stages of ocular inflammation grade throughout the study period (June 07-July 09)

  13. Results: Cataracts • The percent of cataracts that either started during study or during the study, and whether or not they worsened throughout the study period (June 07-July 09)

  14. Results: Medications for Cataract Eyes • Number of Cataract Eyes treated with each drug type

  15. Conclusion • The data does not support the hypothesis because • Cataracts did not worsen • Although visual acuity was only slightly improved, it mostly remained stable • Ocular inflammation was mostly eradicated by end of study Ocular steroids and antimetabolites are the most effective treatment combination at limiting the number of adverse ocular events

  16. Acknowledgments • I would like to thank Dr. Katy Tai, Dr. C. Michael Samson and Dr. Sanjay Kedhar for aiding me in my research

  17. References • 1. Nuclear Sclerotic Cataract. (2003). Retrieved August 14, 2009, from http://dro.hs.columbia.edu/ns.htm • 2. Posterior Subcapsular Cataract. (2003). Retrieved August 14, 2009, from http://dro.hs.columbia.edu/psc.htm • 3. Cortical Cataract. (2003). Retrieved August 14, 2009, from http://dro.hs.columbia.edu/corticalcat.htm • 4. Cataracts-Causes. (Reviewed 2008). Retrieved August 14, 2009, from http://www.umm.edu/patiented/articles/what_causes_cataracts_000026_2.htm • 5. Statistics on Eye Problems, Injuries and Diseases (2007). Retrieved August 14, 2009, from http://www.allaboutvision.com/resources/statistics-eye-diseases.htm • 6. Types of Chemotherapy (Reviewed 2006). Retrieved August 22, 2009, from http://www.uihealthcare.com/topics/medicaldepartments/cancercenter/chemowhattoexpect/types.html • 7. Parts of the Eye, Retrieved August 22, 2009, from http://www.cis.rit.edu/people/faculty/montag/vandplite/pages/chap_8/ch8p3.html

  18. References Cont. • 8. Uveitis. Retrieved August 22, 2009 from http://www.mayoclinic.com/health/uveitis/DS00677 • 9. What Are Autoimmune Diseases? Retrieved August 22, 2009 from http://arthritis.about.com/od/diseasesandconditions/g/autoimmune.htm • 10. Galor, A., Margolis, R., Brasil, OM., Perez, VL., Kaiser, PK., Sears, JE., et al. (2007). Adverse Events after IntravitrealTriamcinolone in Patients with and without Uveitis. Opthalmology volume 114, 1912-1918. • 11. Lightman, Susan (1991). Use of Steroids and immunosuppressive drugs in the management of posterior Uveitis. Eye, 10, 294-298. • 12. Cobo-Ibanez, T., Del Carmen Ordonez, M., Munoz-Fernandez, S., Madero-Prado, R., Martin-Mola, E. (2008). Do TNF-blockers reduce or induce Uveitis? Rheumatology, 47, 731-732.

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