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Erschienen in: Current Treatment Options in Neurology 8/2019

01.08.2019 | Neurologic Ophthalmology and Otology (R Shin and D Gold, Section Editors)

Treatment Strategies for Neuroretinitis: Current Options and Emerging Therapies

verfasst von: Aaron M. Fairbanks, MD, Matthew R. Starr, MD, John J. Chen, MD, PhD, M. Tariq Bhatti, MD

Erschienen in: Current Treatment Options in Neurology | Ausgabe 8/2019

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Abstract

Purpose of review

To explore and critically appraise the published data on the current and emerging treatment modalities for neuroretinitis.

Recent findings

The optimum treatment strategy for neuroretinitis due to Bartonella henselae in immunocompetent individuals is not clear and a matter of debate. The role of systemic corticosteroids in infectious neuroretinitis and the optimum immunosuppressive regimen for use in recurrent idiopathic neuroretinitis also remains ill defined.

Summary

There is no class 1 evidence to support a specific treatment strategy for neuroretinitis. For uncomplicated B. henselae–associated neuroretinitis in immunocompetent patients, initiation of antibiotic and corticosteroid therapy remains controversial. In patients with severe vision loss and/or moderate to severe systemic symptoms, a 4- to 6-week regimen of doxycycline or azithromycin with rifampin may provide some benefit. The routine use of systemic corticosteroids in infectious neuroretinitis is not recommended. Targeted antimicrobial agents should be instituted in cases of neuroretinitis due to specific infectious etiologies (e.g., syphilis, Lyme disease, tuberculosis). Azathioprine may be beneficial in cases of recurrent idiopathic neuroretinitis. There is a need for collaborative, multicenter prospective studies to provide definitive guidelines regarding the use of antibiotics and corticosteroids and to evaluate future therapies in infectious and recurrent idiopathic neuroretinitis.
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Metadaten
Titel
Treatment Strategies for Neuroretinitis: Current Options and Emerging Therapies
verfasst von
Aaron M. Fairbanks, MD
Matthew R. Starr, MD
John J. Chen, MD, PhD
M. Tariq Bhatti, MD
Publikationsdatum
01.08.2019
Verlag
Springer US
Erschienen in
Current Treatment Options in Neurology / Ausgabe 8/2019
Print ISSN: 1092-8480
Elektronische ISSN: 1534-3138
DOI
https://doi.org/10.1007/s11940-019-0579-9

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