부산대학교 도서관

Isolated ocular infections that currently require systemic therapy or prophylaxis, such as viral infections, toxoplasmosis, and certain cases of tuberculous uveitis for example, would greatly benefit from long-lasting local drug delivery systems. Local ocular therapies nevertheless can play a role in patients who are unable to tolerate systemic treatment (i.e., pancytopenia as a side effect of ganciclovir treatment). In general, if I see a role for anti-inflammatory treatment with systemic prednisolone - for example, in toxoplasmic retinochoroiditis - I like to see a response to the antimicrobial drug(s) or at least allow time for antimicrobial therapy to have had sufficient time to take effect before starting prednisolone, and I watch carefully to ensure there is no progression after starting this agent. B SPC b :Generally, I prefer to start the antimicrobial therapy 48-72 hours ahead of the corticosteroid/immunomodulatory therapy to allow time for the former to take effect. In a nutshell, sometimes stop the current treatment, re-analyse the case for potential differentials that might have been overlooked, and if none, then start appropriately and slowly increase immunosuppressive therapy (under cover of antimicrobials). B AG b :Traditionally, CMV retinitis was seen in patients with HIV infection and manifested as a perivascular chronic retinitis that progressed rather slowly and was accompanied by minimal anterior chamber or vitreous reaction. [Extracted from the article]