Combination of antibiotics and steroids promising for uveal lymphoid hyperplasia treatment: BMJ

USA: A recent study has suggested that a combination of oral antibiotics and steroids is a reasonable treatment for select cases of uveal lymphoid hyperplasia.

The findings, published in the British Journal Of Ophthalmology,indicate that this approach could offer an effective and less invasive treatment for select cases of uveal lymphoid hyperplasia, potentially avoiding the need for systemic chemotherapy, monoclonal antibody therapy, or external beam irradiation.

Uveal lymphoid hyperplasia ranges from reactive hyperplasia to low-grade lymphoid neoplasm.Jasmine H. Francis and the teamexplored the response of uveal lymphoid hyperplasia to a combination of oral antibiotics and steroids, providing insights into potential alternative treatment options.

The study included four eyes of three patients diagnosed with uveal lymphoid hyperplasia. The patients were treated with a course of oral antibiotics and steroids. The main outcome measure was the clinical response of the choroidal infiltrate, assessed through optical coherence tomography (OCT) measurements of choroidal thickness and visual acuity. Secondary outcomes included local and systemic recurrence.

The results showed that all four eyes displayed a clinical response within a median of two weeks after starting the antibiotic and steroid treatment. The choroidal infiltration regressed, as evidenced by a decrease in choroidal thickness by a median of 421 nm. The patients also experienced a myopic shift in refractive error by a median of 0.50 Diopters and an improvement in vision by a median of 1.5 Snellen lines. Importantly, during a median follow-up period of 51 months, all four eyes maintained a sustained complete response, and no systemic disease was observed in any of the patients.

Based on this small cohort study, the combination of antibiotics and steroids showed measurable and sustained clinical responses in patients with uveal lymphoid hyperplasia. The findings suggest that this treatment approach could be viable for select cases of uveal lymphoid hyperplasia, potentially eliminating the need for more aggressive treatments such as systemic chemotherapy, monoclonal antibody therapy, or external beam irradiation.

Further research is needed to validate these findings and determine the long-term efficacy and safety of antibiotic and steroid therapy for uveal lymphoid hyperplasia. However, these initial results offer hope for patients with this condition and provide an alternative treatment option that may minimize the need for more invasive interventions.

Reference:

Francis, J. H., Winebrake, J. P., & Abramson, D. H. (2023). Uveal lymphoid hyperplasia: treatment with combination antibiotics and steroids. The British Journal of Ophthalmology, 107(6), 786–789. https://doi.org/10.1136/bjophthalmol-2021-319483