Side effects of treatments

Treatment side effects are one aspect that impacts the quality of life of uveitis patients. Some side effects may resolve on their own, when treatment is completed or with some simple solutions. Others leave sequelae that require medical attention, such as: cataract, glaucoma, osteoporosis, etc. Many of the treatments fundamentally suppress the patient's immune system. Therefore, patients are obliged to make adjustments to their lifestyle and implement measures to prevent the development of infections. Sometimes, side effects can cause complications if they are not managed in time and properly. Prevention and proper management are the most important factors to avoid the emergence of complications that could impoverish patients' quality of life.

This list is not exhaustive and should not replace the recommendations of your doctors. Medications produce different side effects in all people.

Anti-infective agents commonly used to treat ocular Toxoplasmosis

Triple-sulfa

Sulfadiazine

Pyrimethamine

Clindamycin

Trimethoprim-sulfamethoxazole

Spiramycin

Atovaquone

Azithromycin

Clarithromycin

Minocycline

Corticosteroids

Corticosteroids are very infamous for their side effects, although topical corticosteroids produce fewer side effects than systemic corticosteroids. They are difficult to tolerate and produce unpleasant effects, especially in moderate or high doses. The immune system of patients under treatment with moderate or high doses of corticosteroids is suppressed. Therefore, proper administration and prevention are key to avoid the development of infections and other complications.

Topical corticosteroids

• Increased intraocular pressure

• Cataract

• Increased risk of infections

Systemic corticosteroids

• Acne

• Alopecia (hair loss) or thinning hair

• Anxiety

• Increased appetite

• Weight gain

• Increased intraocular pressure

• Cataract

• Changes in sleep patterns or difficulty sleeping

• Metabolic changes

• Cushingoid habitus

• Depression

• Diabetes mellitus

• Decreased growth in children

• Euphoria

• Secondary glaucoma

• Hyperglycemia

• Hypertension

• Swelling

• Irritability

• Adrenocortical insufficiency

• Osteoporosis

• Osteonecrosis

• Psychosis

• Redistribution of body fat

• Slow wound healing

• Growth delay

• Increased risk of infections

• Tremors

• Myopathy

Peri-ocular corticosteroids

• Increased intraocular pressure

• Cataract

• Secondary glaucoma

• Drooping eyelids (ptosis)

Immunomodulators

At first glance, immunomodulators cause much more apprehension than corticosteroids. They may cause concern in patients or their loved ones. However, their administration as a long-term treatment is much safer than prolonged treatment with corticosteroids. It is also a treatment that can be well tolerated by patients, provided it is managed responsibly by a physician. They are chemotherapeutic drugs, so they are not exempt from producing side effects or complications; although, generally, the main risk associated with this treatment is an increase in the risk of contracting infections. Under preventive measures and some lifestyle adjustments, this can be managed satisfactorily.

Antimetabolites

• Increased liver enzymes

• Diarrhea

• Fatigue or extreme tiredness

• Hepatotoxicity

• Bone marrow toxicity

• Nausea

• Vomiting

• Susceptibility to infections

T-cell inhibitors

• Anemia

• Diarrhea

• Fatigue or extreme tiredness

• Gingival hyperplasia

• Hypertension

• Hirsutism

• Nausea

• Paresthesias

• Increased risk of infections

• Toxicity or renal disease

Alkylating agents

• Pure erythrocyte aplasia (PRCA)

• Increased risk of infections

• Hemorrhagic cystitis

• Gingivitis

• Fatigue or extreme tiredness

• Hepatotoxicity

• Hypertension

• Hirsutism

• Infertility

• Nausea

• Nephrotoxicity

• Neutropenia

• Progressive multifocal leukoencephalopathy (PML)

• Risk of developing lymphoma

Biological agents

• Increased risk of developing lymphoma

• Increased risk of infections

• Depression

• Diarrhea

• Abdominal pain

• Headache

• Fatigue or extreme tiredness

• Respiratory tract infections

• Irritation in the injection area

• Nausea

• Skin irritability, rashes or rashes

Cycloplegics/mydriatics

• Delirium

• Mental and/or emotional fluctuations

• Fever

• Irritability

• Dizziness

• Dry mouth

• Tachycardia

• Blurred vision