[Alternatives to steroid therapy in chronic uveitis].

Abstract

In a search for alternative therapeutic methods other than corticosteroids and cytostatics, the effect of a dialyzable leukocyte extract (DLE), the antimetabolite 5-fluorouracil and the immunosuppressive agent cyclosporin A in corticosteroid-resistant idiopathic uveitis was studied. When DLE was administered to 26 patients who had uveitis forms with exogenous triggering (e.g., infection), as well as forms with an autoimmune background, there was a reduction in the number and duration of recurrences and a statistically proven prolongation of the inflammation-free intervals. This was particularly true in anterior and posterior uveitis and to a lesser extent in the intermediate form. No side effects were observed. 5-Fluorouracil, injected subconjunctivally, is indicated in intermediate uveitis with marked vitreous infiltration and beginning proliferation. Corneal erosion occurs relatively often. During treatment with cyclosporin A (low dose, 5 mg/kg of body weight per day), 14 of 17 patients (9 with intermediate uveitis, 6 with retinal vasculitis, 1 with sympathetic ophthalmia, 1 with panuveitis) showed improved results; in 2 cases the findings remained stationary and only 1 case had low-grade deterioration. If one takes into consideration the fact that in this patient any therapy would have failed, the results are convincing. This is particularly true of retinal vasculitis. There is no effect in cases of central hemorrhagic chorioretinopathy. So far, there have been no serious side effects.

• Authors: S Klein, H J Fricke, B Fricke, R Friedrich, A Illessy, K D Schröder
• Journal: Fortschritte der Ophthalmologie : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft (Fortschr Ophthalmol) Vol. 87 Issue 4 Pg. 355-8 ( 1990) ISSN: 0723-8045 [Print] Germany
• Vernacular Title: Alternativen zur Steroidtherapie bei der chronischen Uveitis.
• PMID: 2210561 (Publication Type: English Abstract, Journal Article)

Chemical References

• Adrenal Cortex Hormones
• Cell Extracts
• Cyclosporins
• Fluorouracil

Topics

• Adrenal Cortex Hormones (therapeutic use)
• Adult
• Cell Extracts (therapeutic use)
• Child
• Chronic Disease
• Cyclosporins (therapeutic use)
• Fluorouracil (therapeutic use)
• Humans
• Leukocytes
• Uveitis (drug therapy, therapy)