Twenty-one eyes of 11 patients with immune
posterior uveitis under
tacrolimus treatment were prospectively followed for 1 to 5 years.
Tacrolimus dosage was adjusted to maintain blood levels in the range of 7 to 10 ng/mL. Systemic and ophthalmic evaluations were performed at baseline and during follow-up.
RESULTS: After a mean follow-up of 45 months, no treatment other than
tacrolimus was necessary to control the
inflammation in 6 cases (54.5%). The number of annual recurrences decreased from 3.2 to 1.29 during
tacrolimus treatment (p=0.021). In four patients,
tacrolimus was suspended after a treatment period of 27+/-3.5 months and a follow-up period of 12 months free of
uveitis relapses. All four were free from relapses following
tacrolimus withdrawal. Visual acuity remained unchanged in 16/21 (76%) eyes, deteriorated in 4/21 (19%), and improved in 1/21 (5%). Renal function transiently deteriorated in four patients from basal serum
creatinine levels of 0.84, 1.1, 0.88, and 0.78 mg/dL to maximum levels of 1.33, 2.48, 1.38, and 1.39 mg/dL, respectively. This deterioration was directly related with elevated
tacrolimus serum levels, returning to normal when doses were reduced. During the overall controlled evolution period, a slight increase of serum
creatinine from a basal value of 0.89+/-0.2 mg/dL to a final of 1+/-0.19 mg/dL was detected, which was not statistically significant. All secondary effects were mild, transient, and did not require interruption of long-term treatment to be controlled.
CONCLUSIONS: