In patients with progressive AZOOR who demonstrate enlarging zones of outer retinal loss despite corticosteroid therapy, how do you determine when to escalate to steroid-sparing immunomodulatory agents?  

We should first be sure this is not a "masquerade" syndrome such as vitreoretinal lymphoma, infectious uveitis, or IRD. If these are considered unlikely, then at this point in the course where there is documented progression of a presumed inflammatory process, systemic IMT should be considered. Some...