Clinical outcome of chronic immunosuppression in patients with non-infectious uveitis
- 24 January 2005
- journal article
- Published by Wiley in Clinical & Experimental Ophthalmology
- Vol. 33 (1), 16-21
- https://doi.org/10.1111/j.1442-9071.2005.00904.x
Abstract
Aim: To determine the visual outcome and corticosteroid dose requirement in patients with non-infectious uveitis affecting the posterior segment treated with corticosteroids and additional second-line immunosuppression. Method: A retrospective, non-comparative case series was carried out. Seventy-two patients (141 eyes) with uncontrolled non-infectious uveitis on systemic prednisolone were treated with at least one second-line immunosuppressive agent in addition to systemic prednisolone and followed for at least 3 months. Visual acuity (VA), clinical disease activity, corticosteroid-sparing effect, disease relapses requiring corticosteroid dose increase, and side-effects from second-line agents were evaluated. Results: At the end of the follow-up period (mean: 55.5 months), 70 eyes (49.6%) had VA of 6/9 or better. There was a reduction in the mean maintenance dose of prednisolone required before the introduction of the second-line agent (19 mg/day ± 2 SE) when compared to the mean maintenance dose of prednisolone at the end of the data collection (9 mg/day ± 1 SE; P < 0.001). There was also a significant reduction in the number of disease relapses requiring an increase in prednisolone dose after starting the second-line agents as compared to the year before (P < 0.02). Conclusion: In patients with uveitis affecting the posterior segment, the addition of all second-line immunosuppressive therapy was effective in allowing reduction of the dose of systemic prednisolone to 10 mg/day or less, in controlling intraocular inflammation, reducing the number of relapses and in maintaining vision. Because of their side-effects, immunosuppressive treatment should be individualized and monitored closely but its addition is beneficial in the short and longer term.Keywords
This publication has 40 references indexed in Scilit:
- Infecciones oportunistas en pacientes con enfermedad inflamatoria intestinal bajo tratamiento inmunosupresorGastroenterología y Hepatología, 2003
- Effects of changing immunosuppressive regimen on the incidence, duration, and viral load of cytomegalovirus infection in renal transplantation: a single center reportTransplant Infectious Disease, 2002
- Efficacy and safety of chlorambucil in intractable noninfectious uveitisOphthalmology, 2002
- Methotrexate treatment for sarcoid-associated panuveitisOphthalmology, 1999
- Systemic corticosteroid therapy---side effects and their managementBritish Journal of Ophthalmology, 1998
- Corticosteroids and peptic ulcer: meta‐analysis of adverse events during steroid therapyJournal of Internal Medicine, 1994
- Treatment of autoimmune uveoretinitis in the rat with rapamycin, an inhibitor of lymphocyte growth factor signal transductionCurrent Eye Research, 1993
- Preclinical and clinical study of FK506 in uveitisCurrent Eye Research, 1992
- Immune mechanisms in choroido-retinal inflammation in manEye, 1990
- Renal Histopathologic Alterations in Patients Treated with Cyclosporine for UveitisNew England Journal of Medicine, 1986