Managing Uveitis During the COVID-19 Pandemic
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Treatment of infectious uveitis continues to involve systemic anti-microbial and antiinflammatory drugs, sometimes supplemented with intravitreally injected preparations. The World Health Organization issued a warning that individuals with tuberculosis and COVID-19 may have worse outcomes, particularly if the anti-tubercular therapy is interrupted. SARSCoV-2 has been detected in the blood during acute infection, and intraocular tissues express angiotensin converting enzyme (ACE).

While immunomodulatory drugs are continued in patients with non-infectious uveitis, standard measures to limit the spread of COVID-19 –hand hygiene, distancing and selfisolation– and influenza vaccination are recommended. Inflammatory cystoid macular edema and choroidal neovascularization are reviewed regularly, although a decision for retreatment may be based on clinical findings alone.

One special situation is the patient with non-infectious uveitis who is infected with SARS-CoV-2, whether asymptomatic or suffering with COVID-19.
- The uveitis specialist works closely with the other treating physicians, and immunomodulatory treatment is held or tapered temporarily.
- In-person assessments are undertaken with PPE.
- Locally delivered corticosteroid is an option to avoid systemic drug activity, corticosteroid eye drops are highly effective for anterior uveitis, and periocular and intraocular corticosteroids.

Long-term impact: Experience gained during the COVID-19 pandemic on the use of immunomodulatory drugs in non-infectious uveitis will inform future treatment approaches.