ABSTRACT
As has been highlighted in chapter 4, the treatment of posterior segment
intraocular inflammation (PSII) requires an individualized approach based on the
particular disease process, severity, systemic manifestations, age, sex, and
medical history of each patient. Determining appropriate treatment requires
experience and knowledge of the action and safety of the drugs we use, more so
because it requires a process of drug trial and suitable and timely amendments
to therapy. For example, specific agents may be started then discontinued due to
inadequate efficacy, onset of adverse effects, or with the plan to only use the agent
for a short period of time while waiting for a second agent to “kick in.”
Sometimes treatments are initiated as a “diagnostic trial” in patients without an
established diagnosis. Ineffectiveness of a treatment may indicate either that a
presumed diagnosis is incorrect or it may merely mean that there has been
inadequate immunosuppression (e.g., not high enough dosage; requires a change
to more potent immunosuppressive agent or requires triple therapy). Such
management issues have been covered in previous chapters.
