| 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. |
| Authors | Victor Menezo, Chun Lau, Marie Comer, Susan Lightman
(Affiliation: Departmentof Clinical Ophthalmology, Institute of Ophthalmology, MoorfieldsEye Hospital, UK.)
|
| Journal | Clinical & experimental ophthalmology
(Clin Experiment Ophthalmol)
Vol. 33
Issue 1
Pg. 16-21
(Feb 2005)
ISSN: 1442-6404 Australia |
| PMID | 15670073
(Publication Type: Journal Article)
|
| Chemical References |
- Glucocorticoids
- Immunosuppressive Agents
- Prednisolone
|
| Topics |
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Drug Therapy, Combination
- Female
- Glucocorticoids
(administration & dosage)
- Humans
- Immune Tolerance
- Immunosuppressive Agents
(administration & dosage)
- Male
- Middle Aged
- Prednisolone
(administration & dosage)
- Retrospective Studies
- Treatment Outcome
- Uveitis, Posterior
(drug therapy, physiopathology)
- Visual Acuity
|
