Neglected issues about Uveitis in Pregnancy:
✅ Patients with uveitis who wish to get pregnant need to consider the risks and benefits of any systemic medication.
✅ Prednisolone ≤15mg daily is probably safe in the first trimester and throughout pregnancy.
✅ Fewer data on other immunosuppressive agents so avoid if possible .
✅ Transplant patients (azathioprine, ciclosporin, and mycophenolate ) can be used in pregnancy at the lowest effective dose.
✅ Many of the drugs can be found in breast milk, and this information must be given to mothers wishing to breast feed( considering complications versus benefits)
✅ The influence of pregnancy on the course of uveitis is an extremely interesting phenomenon as uveitis commonly improves during pregnancy, especially from mid pregnancy onwards
✅ The 1st 4 months and the postpartum period is associated with uveitis activity relapse.
✅ Clinicians may consider decreasing uveitis medications during pregnancy to minimise medication associated side effects on the foetus.
✅ After delivery, intensifying followup in anticipation of postpartum relapse.
✅ Autoimmune responses during pregnancy 擄 decrease (important for avoidance of fetal rejection) , this may be the cause of fascinating Uveitis phenomenon during pregnancy 擄.
✅ Future studies on the mechanisms behind uveitis amelioration in pregnancy would inspire new therapeutic options for uveitis ( my own wishes )
✅ Periocular steroids may be used during pregnancy and breastfeeding, and can be given bilaterally if necessary, even extremely small amount is systematically absorbed and is not thought to harm the fetus.
✅ Patients with reactivation of toxoplasma retinochoroiditis present no infective risk to their babies, but consider which drugs can be used safely( spiramycin).
✅ Patients developing primary toxoplasma infection, even if apparently in the eye alone, must be made aware that this is a systemic infection which carries a serious risk of fetal involvement, the extent of which depends on the stage of the pregnancy.
Uveitis
- Julie Jantzi, O.D. Mallory Cranmer, O.D. Neal Shastri, O.D. Noushin Ahmed, O.D. Seidenberg Protzko Eye Associates
- Epidemiology • ~15 per 100,000 in U.S. each year • Causes 10% of blindness in U.S. • Third leading cause of blindness in developed countries • Prevalence varies by location, age, and date of study • Highest among >65 years of age • Females • Chronic and unilateral • Anterior Uveitis most common
- Pathophysiology • Inflammation of the uvea • Infectious, traumatic, neoplastic, autoimmune, idiopathic • Inflammatory response: chemical mediators result in vasodilation, increased vascular permeability, and chemotaxis of inflammatory cells in eye.
Uveitis in Systemic Diseases
Uveitis in Systemic Diseases Supervised by : Dr.Wafaa Al-Sakaji. Presented by : Dr.Mohammad Dmour-PGY1 Ophthalmology Department- Islamic Hospital February 9.2017.
Introduction • The uvea consists of the middle, pigmented, vascular layer of the eye and includes the iris, ciliary body, and choroid. • Uveitis is broadly defined as inflammation of the uvea, and may be accompanied by involvement of other ocular structures such as the retina, sclera, cornea, vitreous, and optic nerve.
Uveitis in Pregnancy Videos :
Uveitis lecture 1 part 1 – YouTube
Ophthalmology – Uvea Class1: Overview of uveitis Part1 – YouTube
Uveitis in Pregnancy
