From the Guidelines
The treatment for pelvicaliectasis associated with uveitis should involve a multidisciplinary approach, including topical corticosteroids and immunomodulatory therapy, with a focus on addressing the underlying inflammatory or autoimmune pathophysiology. For the uveitis component, topical corticosteroids such as prednisolone acetate 1% eye drops administered 4-6 times daily are the first-line treatment, often supplemented with cycloplegic agents like atropine 1% or cyclopentolate 1% to prevent synechiae formation and relieve pain 1. In more severe cases, systemic corticosteroids (prednisone 1 mg/kg/day) may be necessary, with a gradual taper over several weeks.
For the pelvicaliectasis (dilation of the renal pelvis and calyces), treatment depends on the underlying cause, which often involves addressing any urinary obstruction. If the condition is part of a systemic inflammatory disorder like sarcoidosis or ankylosing spondylitis affecting both eyes and kidneys, immunomodulatory therapy such as methotrexate (15-25 mg weekly), azathioprine (2-3 mg/kg/day), or biologics like adalimumab (40 mg subcutaneously every 2 weeks) may be indicated 1. Regular monitoring of both ocular inflammation and renal function is essential, with urological intervention such as stenting or nephrostomy potentially needed if significant obstruction exists.
Key considerations in the treatment approach include:
- The use of noncorticosteroid systemic immunomodulatory therapy, such as methotrexate, azathioprine, or biologics like adalimumab, for the treatment of noninfectious uveitis 1
- The importance of a multidisciplinary approach, involving collaboration between ophthalmologists, rheumatologists, and urologists, to address the complex pathophysiology of pelvicaliectasis and uveitis 1
- The need for regular monitoring of both ocular inflammation and renal function to guide treatment decisions and prevent complications 1
From the Research
Treatment for Pelvicaliectasis associated with Uveitis
There are no research papers directly addressing the treatment for Pelvicaliectasis associated with uveitis. However, the following information on uveitis treatment may be relevant:
- Uveitis is typically treated with corticosteroids, which can be administered systemically or locally 2.
- Corticosteroids are effective in controlling inflammation, but they can have serious side effects and are not suitable for long-term therapy 2, 3.
- In cases of severe or refractory uveitis, disease-modifying antirheumatic drugs (DMARDs) and biologic agents may be used 3, 4.
- DMARDs such as methotrexate, azathioprine, and mycophenolate mofetil can be used to treat chronic and intractable uveitis 5, 4.
- Biologic agents like infliximab, adalimumab, and tocilizumab have shown promise in treating uveitis, especially in cases that are refractory to other treatments 3, 6, 4.
- The treatment approach may vary depending on the severity and type of uveitis, as well as the patient's overall health and medical history.