Medications

Over the past decade, medications have emerged as the preferred treatment for many retinal conditions such as exudative macular degeneration, diabetic retinopathy, and retinal vein occlusions.  These include FDA approved medications such as anti-VEGF inhibitors Lucentis and Eylea and off label use of Avastin.  Steroid medications approved for intravitreal usage include Ozurdex and Iluvien.  Off label FDA approved drugs such as Triescence, a form of dexamethasone are also used in the eye.  These medications are administered in the office using topical anesthetic agents on a routine basis by  retinal specialists and are generally safe and effective for many conditions. They are injected in the vitreous cavity with little discomfort as frequently as monthly.  Steroid medications last for at least 3 months and some have a duration of action as long as 3 years.  Many companies are developing longer-lasting medications or long-term delivery systems.

Uveitis patients can sometimes avoid complications of long term systemic steroid use with steroid implants surgically inserted into the eye such as Ozurdex and Retisert for some inflammatory conditions.  Immunosuppressive therapies used in the treatment of uveitis includemethotrexate, azathioprine, and mycophenolate mofetil. More recently, options available to treat people with severe uveitis that does not respond to other therapies include tumor necrosis factor (TNF) blockers such as adalimumab (Humira) (injected under the skin.   Acthar, an FDA approved medication since 1952 may help uveitis patients via stimulation of the body’s own endogenous steroid production and potential direct anti-inflammatory and immunomodulatory properties.