Ophthalmic Risks and Complications Associated with the Treatment of Systemic Vasculitis

A number of medications used to treat autoimmune systemic vasculitis may lead to ophthalmic complications. Long-term corticosteroid use may lead to cataract, glaucoma or, rarely, central serous chorioretinopathy. Corticosteroid-sparing immunosuppressive medications, particularly cyclophosphamide and/or the biologic agents, may lead to opportunistic eye infections including CMV retinitis, progressive outer retinal necrosis and fungal chorioretinitis due to fungemia. Other medications such as hydroxychloroquine and chloroquine may result in a distinct maculopathy, which may lead to central and paracentral visual loss and loss of color vision. Other medications including rifabutin, which causes uveitis, and bisphosphonates, which may lead to uveitis and scleritis, are also discussed in this chapter.