Skip to main content

Advertisement

SpringerLink
Log in

Uveitis: contrasting the approaches in Japan and the United States

  • Forefront Review
  • Organizer: Annabelle A. Okada, MD, DMSc
  • Published:
Japanese Journal of Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To compare the approaches to uveitis in Japan and the United States.

Methods

This report is based on the author’s personal experience, conversations with Japanese colleagues, and a literature search using the database of the US National Library of Medicine.

Results

The frequencies of specific forms of uveitis vary between the two countries. Options for therapy are affected by government regulations and the impact of insurance carriers. In both countries, there is a stepwise approach to therapy beginning with topical corticosteroids and ultimately advancing to biologics. Despite the differences, the goals for therapy, disease control with minimal toxicity, are the same.

Conclusions

Genetic, environmental, and regulatory differences impact the approach to uveitis. Despite these factors, the goal for therapy is essentially the same.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Rosenbaum JT. Nibbling away at the diagnosis of idiopathic uveitis. JAMA Ophthalmol. 2015;133:146–7.

    Article  PubMed  Google Scholar 

  2. Jabs DA, Busingye J. Approach to the diagnosis of the uveitides. Am J Ophthalmol. 2013;156:228–36.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Jakob E, Reuland MS, Mackensen F, Harsch N, Fleckenstein M, Lorenz HM, et al. Uveitis subtypes in a german interdisciplinary uveitis center–analysis of 1916 patients. J Rheumatol. 2009;36:127–36.

    Article  PubMed  Google Scholar 

  4. Nussenblatt RB. The natural history of uveitis. Int Ophthalmol. 1990;14:303–8.

    Article  CAS  PubMed  Google Scholar 

  5. Durrani OM, Tehrani NN, Marr JE, Moradi P, Stavrou P, Murray PI. Degree, duration, and causes of visual loss in uveitis. Br J Ophthalmol. 2004;88:1159–62.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Rothova A, Suttorp-van Schulten MS, Frits Treffers W, Kijlstra A. Causes and frequency of blindness in patients with intraocular inflammatory disease. Br J Ophthalmol. 1996;80:332–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Suttorp-Schulten MS, Rothova A. The possible impact of uveitis in blindness: a literature survey. Br J Ophthalmol. 1996;80:844–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Harada E. Clinical study of nonsuppurative choroiditis. A report of acute diffuse choroiditis. Acta Soc Ophthalmol Jpn. 1926;30:356.

    Google Scholar 

  9. Ohno S, Ohguchi M, Hirose S, et al. Close association of HLA-Bw51 with Behcet’s disease. Arch Ophthalmol. 1982;100:1455–8.

    Article  CAS  Google Scholar 

  10. Goda C, Kotake S, Ichiishi A, Namba K, Kitaichi N, Ohno S. Clinical features in tubulointerstitial nephritis and uveitis (TINU) syndrome. Am J Ophthalmol. 2005;140:637–41.

    Article  PubMed  Google Scholar 

  11. Umazume A, Kezuka T, Okunuki Y, Ooshita M, Usui Y, Hirano M, et al. Prediction of severe cardiac involvement by fundus lesion in sarcoidosis. Jpn J Ophthalmol. 2014;58:81–5.

    Article  PubMed  Google Scholar 

  12. Saga U, Ozawa H, Soshi S, Nagahara K, Akeo K, Kimura C, et al. Acute retinal necrosis (Kirisawa’s uveitis). Jpn J Ophthalmol. 1983;27:353–61.

    CAS  PubMed  Google Scholar 

  13. Ohguro N, Sonoda KH, Takeuchi M, Matsumura M, Mochizuki M. The 2009 prospective multi-center epidemiologic survey of uveitis in Japan. Jpn J Ophthalmol. 2012;56:432–5.

    Article  PubMed  Google Scholar 

  14. McCannel CA, Holland GN, Helm CJ, Cornell PJ, Winston JY, Rimmer TG, et al. Causes of Uveitis in the General Practice of Ophthalmology. Am J Ophthalmol. 1996;121:35–46.

    Article  CAS  PubMed  Google Scholar 

  15. Rosenbaum JT. Uveitis. An internist’s view. Arch Intern Med. 1989;149:1173–6.

    Article  CAS  PubMed  Google Scholar 

  16. Rosenbaum JT, Wernick R. The utility of routine screening of patients with uveitis for systemic lupus erythematosus or tuberculosis. A Bayesian analysis. Arch Ophthalmol. 1990;108:1291–3.

    Article  CAS  PubMed  Google Scholar 

  17. Han YS, Rivera-Grana E, Salek S, Rosenbaum JT. Distinguishing Uveitis Secondary to Sarcoidosis From Idiopathic Disease: Cardiac Implications. JAMA Ophthalmol. 2018;136:109–15.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Tessler HH, Jennings T. High-dose short-term chlorambucil for intractable sympathetic ophthalmia and Behcet’s disease. Br J Ophthalmol. 1990;74:353–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Ocular Behcet’s Disease Research Group Of J, Okada AA, Goto H, Ohno S, Mochizuki M. Multicenter study of infliximab for refractory uveoretinitis in Behcet disease. Arch Ophthalmol. 2012;130:592–8.

    Article  Google Scholar 

  20. Hooper PL, Kaplan HJ. Triple agent immunosuppression in serpiginous choroiditis. Ophthalmology. 1991;98:944–51.

    Article  CAS  PubMed  Google Scholar 

  21. Schallhorn JM, Niemeyer KM, Browne EN, Chhetri P, Acharya NR. Difluprednate for the treatment of uveitic cystoid macular edema. Am J Ophthalmol. 2018;191:14–22.

    Article  CAS  PubMed  Google Scholar 

  22. Jaffe GJ, Dick AD, Brezin AP, Nguyen QD, Thorne JE, Kestelyn P, et al. Adalimumab in patients with active noninfectious uveitis. N Engl J Med. 2016;375:932–43.

    Article  CAS  PubMed  Google Scholar 

  23. Nguyen QD, Merrill PT, Jaffe GJ, Dick AD, Kurup SK, Sheppard J, et al. Adalimumab for prevention of uveitic flare in patients with inactive non-infectious uveitis controlled by corticosteroids (VISUAL II): a multicentre, double-masked, randomised, placebo-controlled phase 3 trial. Lancet. 2016;388:1183–92.

    Article  CAS  PubMed  Google Scholar 

  24. Ramanan AV, Dick AD, Jones AP, McKay A, Williamson PR, Compeyrot-Lacassagne S, et al. Adalimumab plus methotrexate for uveitis in juvenile idiopathic arthritis. N Engl J Med. 2017;376:1637–46.

    Article  CAS  PubMed  Google Scholar 

  25. Writing Committee for the Multicenter Uveitis Steroid Treatment T, Follow-up Study Research G, Kempen JH, Altaweel MM, Holbrook JT, Sugar EA, et al. Association between long-lasting intravitreous fluocinolone acetonide implant vs systemic anti-inflammatory therapy and visual acuity at 7 years among patients with intermediate, posterior, or panuveitis. JAMA. 2017;317:1993–2005.

    Article  CAS  Google Scholar 

  26. Dick AD, Rosenbaum JT, Al Dhibi HA, Belfort R Jr, Brezin A, Chee SP, et al. Guidance on noncorticosteroid systemic immunomodulatory therapy in noninfectious uveitis: Fundamentals Of Care for UveitiS (FOCUS) initiative. Ophthalmology. 2018;125(5):757–73.

    Article  Google Scholar 

  27. Levy-Clarke G, Jabs DA, Read RW, Rosenbaum JT, Vitale A, Van Gelder RN. Expert panel recommendations for the use of anti-tumor necrosis factor biologic agents in patients with ocular inflammatory disorders. Ophthalmology. 2014;121(785–96):e3.

    Google Scholar 

  28. Deuter CM, Zierhut M, Mohle A, Vonthein R, Stobiger N, Kotter I. Long-term remission after cessation of interferon-alpha treatment in patients with severe uveitis due to Behcet’s disease. Arthritis Rheum. 2010;62:2796–805.

    Article  CAS  PubMed  Google Scholar 

  29. Furie R, Khamashta M, Merrill JT, Werth VP, Kalunian K, Brohawn P, et al. Anifrolumab, an anti-interferon-alpha receptor monoclonal antibody, in moderate-to-severe systemic lupus erythematosus. Arthritis Rheumatol. 2017;69:376–86.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Esterberg E, Acharya NR. Corticosteroid-sparing therapy: practice patterns among uveitis specialists. J Ophthal Inflamm Infect. 2012;2:21–8.

    Article  CAS  Google Scholar 

  31. Gangaputra S, Newcomb CW, Liesegang TL, Kacmaz RO, Jabs DA, Levy-Clarke GA, et al. Methotrexate for ocular inflammatory diseases. Ophthalmology. 2009;116(2188–98):e1.

    Google Scholar 

  32. Daniel E, Thorne JE, Newcomb CW, Pujari SS, Kacmaz RO, Levy-Clarke GA, et al. Mycophenolate mofetil for ocular inflammation. Am J Ophthalmol. 2010;149(423–32):e1–2.

    Google Scholar 

  33. Pasadhika S, Kempen JH, Newcomb CW, Liesegang TL, Pujari SS, Rosenbaum JT, et al. Azathioprine for ocular inflammatory diseases. Am J Ophthalmol. 2009;148(500–9):e2.

    Google Scholar 

  34. Suhler EB, Thorne JE, Mittal M, Betts KA, Tari S, Camez A, et al. Corticosteroid-related adverse events systematically increase with corticosteroid dose in noninfectious intermediate, posterior, or panuveitis: post hoc analyses from the VISUAL-1 and VISUAL-2 Trials. Ophthalmology. 2017;124:1799–807.

    Article  PubMed  Google Scholar 

  35. Nguyen QD, Hatef E, Kayen B, Macahilig CP, Ibrahim M, Wang J, et al. A cross-sectional study of the current treatment patterns in noninfectious uveitis among specialists in the United States. Ophthalmology. 2011;118:184–90.

    Article  PubMed  Google Scholar 

  36. Dick AD, Tugal-Tutkun I, Foster S, Zierhut M, Melissa Liew SH, Bezlyak V, et al. Secukinumab in the treatment of noninfectious uveitis: results of three randomized, controlled clinical trials. Ophthalmology. 2013;120:777–87.

    Article  PubMed  Google Scholar 

  37. Letko E, Yeh S, Foster CS, Pleyer U, Brigell M, Grosskreutz CL, et al. Efficacy and safety of intravenous secukinumab in noninfectious uveitis requiring steroid-sparing immunosuppressive therapy. Ophthalmology. 2015;122:939–48.

    Article  PubMed  Google Scholar 

  38. Mesquida M, Molins B, Llorenc V, Hernandez MV, Espinosa G, Maza M, et al. Twenty-Four month follow-up of tocilizumab therapy for refractory uveitis-related macular edema. Retina. 2018;38:1361–70.

    Article  CAS  PubMed  Google Scholar 

  39. Fischer JA, Hueber AJ, Wilson S, Galm M, Baum W, Kitson C, et al. Combined inhibition of tumor necrosis factor alpha and interleukin-17 as a therapeutic opportunity in rheumatoid arthritis: development and characterization of a novel bispecific antibody. Arthritis Rheumatol. 2015;67:51–62.

    Article  CAS  PubMed  Google Scholar 

  40. Lasave AF, Schlaen A, Zeballos DG, Diaz-Llopis M, Couto C, El-Haig WM, et al (2017) Twenty-four months follow-up of intravitreal bevacizumab injection versus intravitreal triamcinolone acetonide injection for the management of persistent non-infectious uveitic cystoid macular edema. Ocul Immunol Inflamm 1–9.

  41. Lee EB, Fleischmann R, Hall S, Wilkinson B, Bradley JD, Gruben D, et al. Tofacitinib versus methotrexate in rheumatoid arthritis. N Engl J Med. 2014;370:2377–86.

    Article  CAS  Google Scholar 

  42. Mease P, Hall S, FitzGerald O, van der Heijde D, Merola JF, Avila-Zapata F, et al. Tofacitinib or adalimumab versus placebo for psoriatic arthritis. N Engl J Med. 2017;377:1537–50.

    Article  CAS  Google Scholar 

  43. Olivera P, Danese S, Peyrin-Biroulet L. JAK inhibition in inflammatory bowel disease. Expert Rev Clin Immunol. 2017;13:693–703.

    Article  CAS  PubMed  Google Scholar 

  44. Nguyen QD, Merrill PT, Clark WL, Banker AS, Fardeau C, Franco P, et al. Intravitreal sirolimus for noninfectious uveitis: a phase III sirolimus study assessing double-masKed uveitis TReAtment (SAKURA). Ophthalmology. 2016;123:2413–23.

    Article  PubMed  Google Scholar 

  45. DiCarlo JE, Mahajan VB, Tsang SH. Gene therapy and genome surgery in the retina. J Clin Invest. 2018;128:2177–88.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Martin-Varillas JL, Calvo-Rio V, Beltran E, Sanchez-Burson J, Mesquida M, Adan A, et al. Successful optimization of Adalimumab therapy in refractory uveitis due to Behcet’s disease. Ophthalmology. 2018;125(9):1444–51.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

The author is indebted to Professor Annabelle Okada for constructive comments on the contents of this manuscript and to Sandra Lewis, M.D. for assistance in preparing the bar graph.

Author information

Authors and Affiliations

  1. Casey Eye Institute, Oregon Health and Sciences University, 3375 SW, Terwilliger Blvd, Portland, OR, 97239, USA

    James T. Rosenbaum

  2. Legacy Devers Eye Institute, 1040 NW 22nd Ave, Portland, OR, 97210, USA

    James T. Rosenbaum

Authors
  1. James T. Rosenbaum
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to James T. Rosenbaum.

Ethics declarations

Conflicts of interest

Consultant fees (AbbVie, Eyevensys, Gilead, Janssen, Novartis, Regeneron, Roche, UCB); Clinical trial support (Pfizer).

Additional information

Organizer: Annabelle A. Okada, MD, DMSc.

Corresponding author: James Todd Rosenbaum

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Rosenbaum, J.T. Uveitis: contrasting the approaches in Japan and the United States. Jpn J Ophthalmol 63, 1–6 (2019). https://doi.org/10.1007/s10384-018-0633-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10384-018-0633-2

Keywords

Search

Navigation