Multiple Sclerosis-Associated Uveitis Therapy: Is Modern Better than Old Reliable?

Background: Uveitis, although a rare complication of multiple sclerosis (MS), poses a significant challenge in clinical management. Traditional treatments like corticosteroids, immunosuppressants, and surgical interventions often provide limited efficacy. Treatment for MS-associated uveitis involves a combination of traditional and emerging therapies, with a growing emphasis on monoclonal antibodies (mAbs). While there is an increasing use of disease-modifying therapies for MS such as interferon-beta (IFN-β), mAbs are gaining attention for their potential to address both neurological and ophthalmological symptoms. Methods: We conducted a systematic review of the existing literature and analyzed the clinical effect of IFN-β and mAb therapies in the context of MS-associated uveitis, assessing their efficacy in reducing inflammation, maintaining visual acuity (VA), and minimizing steroid dependency. Results: MS-associated uveitis had improved or maintained VA in 95% (35/37) of eyes (21 patients) after an average of 34.7 months (range of 7.9 to 78.7 months) of IFN-β treatment. One hundred percent (10/10) of patients (19/19 eyes) had improved or maintained VA after a mean of 25 months (range 8 to 43 months) of mAb treatment. We also found that IFN-β effect on MS-associated uveitis is comparable to mAbs. Conclusions: We outline the need for further research through human data to strengthen current findings and guide evidence-based clinical practice.