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Papillitis is a sight-threatening condition involving the optic nerve head which can lead to permanent vision loss without timely effective intervention. Protheragen offers comprehensive preclinical services for the development of diagnostics and therapeutics targeting papillitis.
Papillitis is an inflammatory disease distinguished by the swelling of the optic disc which is often accompanied by some level of distortion of vision alongside potential vision loss. It may manifest in one or both eyes and is sometimes linked with pain when the patient moves their eye. This condition is often regarded as part of optic neuritis, where the optic nerve is inflamed. Additionally, infectious pathogens, autoimmune diseases, and metabolic imbalances can cause papillitis.
Fig.1 Case analysis of fundus photography of right eyes. (Beketova T. R., et al., 2023)Laboratory testing is indispensable in uncovering the causes of papillitis. For example, serology for HSV, CMV, and syphilis helps determine specific pathogens. An example is the diagnosis of HSV-associated optic neuropathy which can be done by PCR of CSF or aqueous humor. Likewise, the diagnosis of MS-related optic neuritis can be supported by the presence of oligoclonal bands in the CSF and elevated protein levels. In the case where there is suspicion of autoimmune involvement, the presence of NMO-IgG antibodies can help distinguish neuromyelitis optica from other inflammatory optic neuropathies.
Antiviral and Antibacterial Therapies
With regards to infectious causes of papillitis, antiviral and antibacterial agents remain the backbone of therapeutics. Acyclovir is effective in treating optic neuropathy secondary to HSV infection as it decreases both the severity and duration of the disease. The same applies to CMV papillitis where ganciclovir and other antiviral agents are used usually in conjunction with systemic steroids to reduce inflammation. In other bacterial infections like syphilitic optic neuritis, inflammation with vision loss can be controlled with a penicillin based regimen.
Corticosteroids and Immunomodulatory Agents
Corticosteroids are often used to manage inflammation caused by papillitis in autoimmune and idiopathic cases. In acute optic neuritis, intravenous methylprednisolone with subsequent oral prednisone is noted to enhance visual recovery and diminish optic nerve injury. In more difficult or resistant cases, some cases may require stronger therapeutics with immune suppressants like azathioprine or mycophenolate mofetil to alter the immune response. In diabetic papilla lesions, periocular steroid injections have been shown to reduce disc edema and increase vision, demonstrating a marked shortening of these effects.
From the creation of a new diagnostic assay to the development of therapeutic plans, Protheragen's specialized offerings have the precision and skill needed to advance therapeutic strategies applied to papillitis.
Protheragen's preclinical research services include a broad array of investigations directed at unraveling the disease mechanism of papillitis and discovering new therapeutic pathways. We undertake both in vitro and in vivo studies to assess the therapeutic index of new pharmacological agents, thereby maintaining a strong pipeline of therapeutic candidates. If you are interested in our services, please feel free to contact us.
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