ABSTRACT
Anterior uveitis presents a diagnostic challenge due to its wide array of etiologies and clinical manifestations. This narrative review aims to equip general ophthalmologists with a comprehensive understanding of anterior uveitis epidemiology, diagnosis, and treatment. Particular emphasis is placed on developing a tailored and stepwise strategy, rather than a one-size-fits-all approach, for the workup and treatment of anterior uveitis. Chest radiography and serologic testing for syphilis, human leukocyte antigen B27, and angiotensin-converting enzyme are appropriate routine investigations in cases of severe, bilateral, recurrent, or chronic anterior uveitis. Additional testing should be guided by clinical findings and regional epidemiology, especially when considering expensive and invasive modalities. Investigations that are obtained in the absence of clinical and epidemiologic orientation are of limited utility and incur significant costs to patients and health care systems. Most cases of anatomically isolated anterior uveitis resolve with topical corticosteroids, but some patients require escalation to systemic immunomodulatory therapy (IMT). IMT should be considered in patients who respond poorly to corticosteroids, develop side effects related to corticosteroids that limit their use, require high doses to maintain disease remission, or have concomitant systemic inflammatory disease. Comprehensive ophthalmologists should feel comfortable comanaging patients that require conventional disease-modifying antirheumatic drugs/antimetabolite therapy (i.e., methotrexate, azathioprine, and mycophenolate mofetil) with rheumatologists and providing guidance on ocular dosing. When uveitis quiescence cannot be achieved despite maximally tolerated antimetabolite therapy, patients should be referred to a uveitis specialist for consultation and consideration of IMT escalation. The timing of uveitis referral may depend on local factors specific to health care jurisdictions.
ABSTRACT
PURPOSE: This cross-sectional study evaluated the prevalence of inclusive author submission guidelines across ophthalmology journals. METHODS: Journals were identified from the 2021 Journal Citations Report (Clarivate Analytics). Independent reviewers rated each author submission guideline as "inclusive" for satisfying at-least one of six criteria: i) included examples of gender inclusive language; ii) recommended the use of gender-inclusive language; iii) distinguished between sex and gender; iv) provided educational resources on gender-inclusive language; v) provided a policy permitting name changes (e.g., in case of gender and name transition); and/or vi) provided a statement of commitment to inclusivity. The primary objective was to investigate the proportion of journals with "gender-inclusive" author submission guidelines and the elements of the gender-inclusive content within these guidelines. A secondary objective was to review the association between "gender-inclusivity" in author submission guidelines with publisher, origin country, and journal/source/influence metrics (Clarivate Analytics). RESULTS: Across 94 journals, 29.8% journals were rated as inclusive. Inclusive journals had significantly higher relative impact factor, citations, and article influence scores compared to non-inclusive journals. Of the 29.8% of inclusive journals, the three most common domains were inclusion of an inclusivity statement (71.4% of inclusive journals), distinguishing between sex and gender (67.9%), and provision of additional educational resources on gender reporting for authors (60.7%). CONCLUSION: A minority of ophthalmology journals have gender-inclusive author submission guidelines. Ophthalmology journals should update their submission guidelines to advance gender equity of both authors and study participants and promote the inclusion of gender-diverse communities.