Curbside Consultation in Uveitis: 49 Clinical Questions

Media Type: Textbook/Monograph

Synopsis: The care of uveitis patients may be complex and daunting in some circumstances, particularly given the risk of “missing” an infectious disease with potentially vision-threatening consequences. While there are a number of excellent, comprehensive textbooks that address detailed pathogenesis, immunologic principles within uveitis, and mechanisms underlying uveitis and treatment options, some situations invariably arise where a “curbside” is needed – a 5-minute answer to a complex situation in “real-time.” Curbside Consultation in Uveitis fills this niche in the literature and provides brief insightful answers to questions regarding the care of uveitis patients that may be used either as a concise reference text or a handy accompaniment to clinic when the questions arise in clinic.

Target Audience: Ophthalmologists and ophthalmologists-in-training

Review: Dr Stephen C. Foster, the Editor of Curbside Consultation in Uveitis , has been a leader in the field of uveitis and ocular immunology for over three decades. With his well-established team of experts including the Associate Editors Dr Mitchel Opremcak and Dr David Hinkle, as well as over 40 internationally-recognized uveitis subspecialists, this book offers insight into clinically-relevant questions regarding the care of uveitis patients. The book’s intended audience ranges from ophthalmology residents to ophthalmologists-in-practice, who are confronted with difficult questions related to uveitis care.

The book is divided into 49 sections based on the uveitis question of interest. These questions range from considerations of broader interest, including the strength of the clinical evidence on immunomodulatory therapy and laboratory testing in patients with uveitis, to more specific scenarios such as therapy for macula-threatening toxoplasmosis and sympathetic ophthalmia. Other patient-specific scenarios, which are infrequent, but critically relevant to this field because of significant risk-benefit discussions, are also included in this monograph. Some of these scenarios include the management of uveitis in pregnant women and special considerations in children with juvenile-idiopathic arthritis. This book is not designed to be a comprehensive text on disease pathogenesis, but rather to focus on points of confusion regarding diagnostic testing in uveitis, approaches to local and systemic immunosuppression, antimicrobial therapy for infectious uveitis, and appropriate timing of referral to a subspecialist.

The general outline and approach to the individual questions varies slightly depending on the subject matter and breadth of the question to be answered. Each response draws on the currently available evidence in the peer-reviewed literature regarding a specific subject matter and the expert opinion of the author. One of the major strengths of the information presented is related to the organization, specifically within the sections, regarding infectious uveitis. General approach to disease, treatment dosages, and follow-up recommendations are highlighted for ocular toxoplasmosis, acute retinal necrosis, cytomegalovirus retinitis, and syphilitic uveitis in a concise, yet thorough manner, which is a very practical tool for the clinician.

There are few criticisms to offer for this monograph given the broad scope and depth of information presented. Because there are multiple authors, some who may have differing opinions on subject matter, controversies remain surrounding the optimal strategy for the treatment of some of these rare disease entities. This monograph, however, presents the relative risks and benefits fairly for each of these treatment strategies so that the provider may make an accurate assessment of all available options and formulate a therapeutic plan with the patient.

In summary, Curbside Consultation in Uveitis offers both general considerations regarding the diagnosis and treatment of uveitis, as well as insights into therapies for specific infectious and noninfectious uveitis syndromes. The concise nature of the chapters, which are organized as a brief response in consultation with a subspecialty provider, makes this text a very informative and practical approach to decision-making for uveitis patient care.

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Jan 9, 2017 | Posted by in OPHTHALMOLOGY | Comments Off on Curbside Consultation in Uveitis: 49 Clinical Questions

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