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Immunosuppressive Therapy for Severe Chronic Uveitis

Immunosuppressive Therapy for Severe Chronic Uveitis Abstract • Twenty-five patients with severe, progressive, chronic uveitis who were poorly responsive or unresponsive to corticosteroid therapy received low-dose prednisone and cytotoxic immunosuppressive therapy. Azathioprine (2.0 to 2.5 mg/kg) or chlorambucil (6 to 8 mg) was combined with prednisone (10 to 15 mg) daily in a long-term therapeutic program. All 25 patients exhibited a therapeutic response. In 18 of 25 patients, complete quiescence of the inflammatory process was observed. The remaining seven patients showed a substantial decrease of uveitis with persistence of some inflammatory changes. Adverse side effects that resulted from this therapy were infrequent. References 1. Perkins ES: Recent advances in the study of uveitis . Br J Ophthalmol 58:432-437, 1974. 2. Wong VG, Hersh EM: Methotrexate in the therapy of cyclitis . Trans Am Acad Ophthalmol Otolaryngol 69:279-293, 1965. 3. Elschnig A: Studien zur sympathischen Ophthalmia: II. Die antigene Wirking des Augenpigments . Graefe Arch Ophthalmol 76:509, 1910.Crossref 4. Macdonald R: Correlative studies on experimental allergic uveo-retinal disease . Trans Ophthalmol Soc 69:397, 1971. 5. Wong VG, Anderson RR, McMaster PRB: Endogenous immune uveitis . Arch Ophthalmol 85:93-102, 1971.Crossref 6. Gamble CN, Aronson SB, Brescia FB: Experimental uveitis: II. The pathogenesis of recurrent immunologic (Auer) uveitis . Arch Ophthalmol 84:331-341, 1970.Crossref 7. Gamble CN, Aronson SB, Brescia FB: Experimental uveitis: I. The production of recurrent immunologic (Auer) uveitis and its relationship to increased uveal vascular permeability . Arch Ophthalmol 84:321-330, 1970.Crossref 8. Eakins KE, Whitelocke E, Bennett RAF, et al: Prostaglandin-like activity in ocular inflammation . Br Med J 3:452-453, 1972.Crossref 9. Aronson SB, McMaster PRB: Passive transfer of experimental allergic uveitis . Arch Ophthalmol 86:557-563, 1971.Crossref 10. Feinberg EB, Shore B, Leopold IH, et al: Cellular immunity in chronic ophthalmic disorders: III. Leukocyte migration inhibition in uveitis . Am J Ophthalmol 73:68-72, 1972. 11. Henley WL, Okas S, Waithe W, et al: Cellular immunity in chronic ophthalmic disorders: I. Lymphocyte stimulation and protein synthesis . Am J Ophthalmol 73:56-61, 1972. 12. Marak GE, Font RL, Johnson MC, et al: Lymphocyte-stimulating activity of ocular tissues in sympathetic ophthalmia . Invest Ophthalmol 10:770-774, 1971. 13. Hammer H: Cellular hypersensitivity to uveal pigment confirmed by leukocyte migration tests in sympathetic ophthalmitis and the Voyt-Koyanagi-Harada syndrome . Br J Ophthalmol 58:773-776, 1974.Crossref 14. Wong VG: Immunosuppressive therapy of ocular inflammatory diseases . Arch Ophthalmol 81:628-637, 1969.Crossref 15. Lazar M, Weiner MJ, Leopold IH: Treatment of uveitis with methotrexate . Am J Ophthalmol 67:383-387, 1972. 16. Buckley SE, Gills JP Jr: Cyclophosphamide therapy of peripheral uveitis . Arch Intern Med 124:29-35, 1969.Crossref 17. Newell FW, Krill AE, Thomson A: The treatment of uveitis with 6-mercaptopurine . Am J Ophthalmol 61:1250-1255, 1966. 18. Mathews JD, Crawford BA, Bignell JL, et al: Azathioprine in active chronic iridocyclitis . Br J Ophthalmol 53:327-330, 1969.Crossref 19. Godfrey WA, Epstein WV, O'Connor GR, et al: The use of chlorambucil in intractable idiopathic uveitis . Am J Ophthalmol 78:415-428, 1974. 20. Wong VG: Immunosuppressive agents in ophthalmology . Surv Ophthalmol 13:290, 1969. 21. Hoover R, Fraumeni JF Jr: Risk of cancer in renal-transplant recipients . Lancet 2:55-57, 1973.Crossref 22. Appen RE: Posterior uveitis and primary cerebral reticulum cell sarcoma . Arch Ophthalmol 93:123-124, 1975.Crossref 23. Klinglee TG, Hogan MJ: Ocular reticulum cell sarcoma . Am J Ophthalmol 79:39-47, 1975. 24. Neault RW, Van Scoy RE, Okazaki H, et al: Uveitis associated with isolated reticulum cell sarcoma of the brain . Am J Ophthalmol 73:431-436, 1972. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

Immunosuppressive Therapy for Severe Chronic Uveitis

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Publisher
American Medical Association
Copyright
Copyright © 1978 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.1978.03910050115002
Publisher site
See Article on Publisher Site

Abstract

Abstract • Twenty-five patients with severe, progressive, chronic uveitis who were poorly responsive or unresponsive to corticosteroid therapy received low-dose prednisone and cytotoxic immunosuppressive therapy. Azathioprine (2.0 to 2.5 mg/kg) or chlorambucil (6 to 8 mg) was combined with prednisone (10 to 15 mg) daily in a long-term therapeutic program. All 25 patients exhibited a therapeutic response. In 18 of 25 patients, complete quiescence of the inflammatory process was observed. The remaining seven patients showed a substantial decrease of uveitis with persistence of some inflammatory changes. Adverse side effects that resulted from this therapy were infrequent. References 1. Perkins ES: Recent advances in the study of uveitis . Br J Ophthalmol 58:432-437, 1974. 2. Wong VG, Hersh EM: Methotrexate in the therapy of cyclitis . Trans Am Acad Ophthalmol Otolaryngol 69:279-293, 1965. 3. Elschnig A: Studien zur sympathischen Ophthalmia: II. Die antigene Wirking des Augenpigments . Graefe Arch Ophthalmol 76:509, 1910.Crossref 4. Macdonald R: Correlative studies on experimental allergic uveo-retinal disease . Trans Ophthalmol Soc 69:397, 1971. 5. Wong VG, Anderson RR, McMaster PRB: Endogenous immune uveitis . Arch Ophthalmol 85:93-102, 1971.Crossref 6. Gamble CN, Aronson SB, Brescia FB: Experimental uveitis: II. The pathogenesis of recurrent immunologic (Auer) uveitis . Arch Ophthalmol 84:331-341, 1970.Crossref 7. Gamble CN, Aronson SB, Brescia FB: Experimental uveitis: I. The production of recurrent immunologic (Auer) uveitis and its relationship to increased uveal vascular permeability . Arch Ophthalmol 84:321-330, 1970.Crossref 8. Eakins KE, Whitelocke E, Bennett RAF, et al: Prostaglandin-like activity in ocular inflammation . Br Med J 3:452-453, 1972.Crossref 9. Aronson SB, McMaster PRB: Passive transfer of experimental allergic uveitis . Arch Ophthalmol 86:557-563, 1971.Crossref 10. Feinberg EB, Shore B, Leopold IH, et al: Cellular immunity in chronic ophthalmic disorders: III. Leukocyte migration inhibition in uveitis . Am J Ophthalmol 73:68-72, 1972. 11. Henley WL, Okas S, Waithe W, et al: Cellular immunity in chronic ophthalmic disorders: I. Lymphocyte stimulation and protein synthesis . Am J Ophthalmol 73:56-61, 1972. 12. Marak GE, Font RL, Johnson MC, et al: Lymphocyte-stimulating activity of ocular tissues in sympathetic ophthalmia . Invest Ophthalmol 10:770-774, 1971. 13. Hammer H: Cellular hypersensitivity to uveal pigment confirmed by leukocyte migration tests in sympathetic ophthalmitis and the Voyt-Koyanagi-Harada syndrome . Br J Ophthalmol 58:773-776, 1974.Crossref 14. Wong VG: Immunosuppressive therapy of ocular inflammatory diseases . Arch Ophthalmol 81:628-637, 1969.Crossref 15. Lazar M, Weiner MJ, Leopold IH: Treatment of uveitis with methotrexate . Am J Ophthalmol 67:383-387, 1972. 16. Buckley SE, Gills JP Jr: Cyclophosphamide therapy of peripheral uveitis . Arch Intern Med 124:29-35, 1969.Crossref 17. Newell FW, Krill AE, Thomson A: The treatment of uveitis with 6-mercaptopurine . Am J Ophthalmol 61:1250-1255, 1966. 18. Mathews JD, Crawford BA, Bignell JL, et al: Azathioprine in active chronic iridocyclitis . Br J Ophthalmol 53:327-330, 1969.Crossref 19. Godfrey WA, Epstein WV, O'Connor GR, et al: The use of chlorambucil in intractable idiopathic uveitis . Am J Ophthalmol 78:415-428, 1974. 20. Wong VG: Immunosuppressive agents in ophthalmology . Surv Ophthalmol 13:290, 1969. 21. Hoover R, Fraumeni JF Jr: Risk of cancer in renal-transplant recipients . Lancet 2:55-57, 1973.Crossref 22. Appen RE: Posterior uveitis and primary cerebral reticulum cell sarcoma . Arch Ophthalmol 93:123-124, 1975.Crossref 23. Klinglee TG, Hogan MJ: Ocular reticulum cell sarcoma . Am J Ophthalmol 79:39-47, 1975. 24. Neault RW, Van Scoy RE, Okazaki H, et al: Uveitis associated with isolated reticulum cell sarcoma of the brain . Am J Ophthalmol 73:431-436, 1972.

Journal

Archives of OphthalmologyAmerican Medical Association

Published: Feb 1, 1978

References