Mechanisms, Pathophysiology and Current Immunomodulatory/Immunosuppressive Therapy of Non-Infectious and/or Immune-Mediated Choroiditis

Papasavvas I., Tugal-Tutkun I., Herbort C. P.

PHARMACEUTICALS, cilt.15, sa.4, 2022 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Derleme
  • Cilt numarası: 15 Sayı: 4
  • Basım Tarihi: 2022
  • Doi Numarası: 10.3390/ph15040398
  • Dergi Adı: PHARMACEUTICALS
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, CAB Abstracts, EMBASE, Veterinary Science Database, Directory of Open Access Journals
  • Anahtar Kelimeler: choriocapillaritis, stromal choroiditis, multimodal imaging, indocyanine green angiography (ICGA), immunosuppressive therapy, biological therapies, VOGT-KOYANAGI-HARADA, INDOCYANINE GREEN ANGIOGRAPHY, CYSTOID MACULAR EDEMA, INTRAVENOUS PULSE METHYLPREDNISOLONE, SUNSET GLOW FUNDUS, TERM-FOLLOW-UP, MYCOPHENOLATE-MOFETIL, BIRDSHOT RETINOCHOROIDOPATHY, SERPIGINOUS CHOROIDITIS, MULTIFOCAL CHOROIDITIS
  • İstanbul Üniversitesi Adresli: Evet

Özet

Non-infectious choroiditis comprises immune-mediated diseases resulting from diverse pathophysiological mechanisms. These conditions are sub-divided into two main groups, (1) diseases of the choriocapillaris and (2) diseases of the choroidal stroma. The purpose of this study is to expose the pathophysiology of the most common diseases of both these groups and recommend the optimal immunomodulatory/immunosuppressive therapy of each analyzed condition based on literature data and data from our own centers. Material and Methods: Narrative review. In the group of choriocapillaritis entities or primary inflammatory choriocapillaropathies (PICCPs) including multiple evanescent white dot syndrome (MEWDS), acute posterior multifocal placoid pigment epitheliopathy (APMPPE), idiopathic multifocal choroiditis (MFC) and serpiginous choroiditis (SC), as well as secondary choriocapillaritides including acute syphilitic posterior multifocal placoid chorioretinitis (ASPMPC) and tuberculosis-related SC (TB-SC), were analyzed. In the group of stromal choroidites, HLA-A29 birdshot retinochoroiditis (BRC) and Vogt-Koyanagi-Harada (VKH) disease were included. For each entity a literature search, in the PubMed database, on treatment was performed and analyzed and the therapeutic attitudes of our own centers were presented. Management of immune-mediated choroiditis implies vigorous immunosuppressive therapy given in a prompt and prolonged fashion in most of these entities.