Treatment of Uveitis with Intraocular Steroids

Uveitis, or inflammation inside the eye, is a relatively uncommon disease. Still it accounts for 10-15 % of all causes of blindness among people of working age in the developed world. Uveitis can be categorized according to anatomical involvement or by etiology such as infectious or noninfectious. In order to maintain normal visual function, the eye must remain an immune-privileged site to which immune cells have restricted access and function. Dysfunction of these immunosuppressive mechanisms results in an uncontrolled intraocular immune response that can lead to irreversible structural damage and loss of visual function. Corticosteroids are the cornerstone treatment for patients with noninfectious uveitis. While they are effective in controlling inflammation, systemic corticosteroids can result in side effects that limit their use. This has prompted the development and use of local steroid treatment in the form of intravitreal steroid injections and intraocular implants. These provide high steroid concentration inside the eye, are effective, and minimize systemic effects. In this chapter, we review the use of intraocular steroids for the treatment of uveitis.