Biologics in the Treatment of Behçet Uveitis

Ocular involvement of Behçet disease is characterized by bilateral, recurrent non-granulomatous panuveitis and retinal vasculitis and may lead to serious retinal damage and loss of vision. Posterior segment involvement is an absolute indication for immunomodulatory therapy in the management of Behçet uveitis. Conventional therapy including steroids and immunosuppressives and interferons may not be sufficient to prevent retinal damage. Besides, adverse reactions related to these agents may limit their usage. In this situation, relatively new biologic agents open new horizons for preventing visual loss related to Behçet uveitis. These agents include tumor necrosis factor-alpha (TNF-Alpha) inhibitors (infliximab, adalimumab, golimumab, etanercept ve certolizumab), IL-1 inhibitors (anakinra, canakinumab, gevokizumab), IL-6 inhibitors (tocilizumab) and B-cell inhibitors (rituximab). This review aims to provide an overview of biologics in the treatment of Behçet uveitis.

Autoimmune Inner Ear Disease: Immune Biomarkers, Audiovestibular Aspects, and Therapeutic Modalities of Cogan’s Syndrome

Cogan’s syndrome (CS) is a rare autoimmune disorder characterized by audiovestibular dysfunction and ocular inflammation. Currently, there is no specific serum autoantibody used in the diagnostic workup of CS. Treatment is based on immunosuppressive agents, mainly corticosteroids as first-line choice. Recently, novel therapeutic modalities in CS have emerged. These include tumor necrosis factor-α inhibitors and other biologicals. Despite medical treatment, hearing loss may progress to irreversible bilateral profound SNHL in approximately half of CS patients resulting in candidacy for cochlear implantation (CI). Due to the inflammatory nature of the disease that is causing endosteal reaction with partial obliteration or complete neoossification of the intracochlear ducts, early CI is recommended. CI provides excellent and stable hearing rehabilitation with high score of word and sentence recognition. In this review, we will discuss different aspects of CS including clinical presentation, diagnosis, treatment, and future directives.