Korean J Ophthalmol.  2012 Feb;26(1):21-25. 10.3341/kjo.2012.26.1.21.

Clinical Outcomes of Cyclosporine Treatment for Noninfectious Uveitis

• Lee SH
• Chung H
• Yu HG

• KMID: 1120177
• DOI: http://doi.org/10.3341/kjo.2012.26.1.21

Abstract

PURPOSE
To assess the clinical outcomes of cyclosporine treatment for noninfectious uveitis.
METHODS
A retrospective review of medical records was completed for 182 noninfectious uveitis patients who were treated with cyclosporine between January 2001 and August 2010. Data was obtained relevant to demographic characteristics, anatomic classification, and laterality of uveitis, associated systemic disorder, dosage of cyclosporine and prednisolone, usage of other immunosuppressive drugs, visual acuity (VA), control of uveitic activity, and adverse effects during the cyclosporine use.
RESULTS
Uveitic activity was controlled to a level of minimal inflammation in 89.0% and completely in 78.6% of patients by the median duration of 49 and 98 days, respectively. Prednisolone-sparing (dose < or =10 mg) control of inflammation equal to or less than the minimal activity was achieved in 75.3% of patients. VA was aggravated more than 0.2 logarithm of the minimum angle of resolution in 17.3% of eyes in spite of cyclosporine treatment for the mean follow-up of 698.4 days. Dose reduction and cessation of cyclosporine was required only in 3.3% and 9.3%, respectively, due to the intolerable toxicity, although 44.0% of patients experienced mild to moderate adverse effects.
CONCLUSIONS
Cyclosporine combined with corticosteroids or other immunosuppressive drugs as needed is an effective treatment for noninfectious uveitis, thus minimizing the adverse effects of corticosteroids and other toxic drugs. However, careful monitoring for the toxicity of cyclosporine is needed, because a small group of patients cannot tolerate its toxicity.

Keyword

Adrenal cortex hormones; Cyclosporine; Immunosuppressive agent; Uveitis

MeSH Terms

Adolescent
Adult
Aged
Cyclosporine/administration & dosage/*therapeutic use
Female
Humans
Immunosuppressive Agents/administration & dosage/*therapeutic use
Kaplan-Meier Estimate
Male
Middle Aged
Prednisolone/administration & dosage/therapeutic use
Republic of Korea
Retrospective Studies
Treatment Outcome
Uveitis/*drug therapy
Visual Acuity

Figure

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  Fig. 1 Kaplan-Meier survival curve showing the uveitis control against time. The upper curve denotes a level equal to or less than "slightly active" and the lower curve denotes a level of "inactive".

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  Fig. 2 Kaplan-Meier survival curve demonstrating the proportion of patients who needed a dose reduction or cessation of cyclosporine due to adverse effects.

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