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Intravenous Pulse Methylprednisolone Therapy in Severe Inflammatory Eye Disease

Intravenous Pulse Methylprednisolone Therapy in Severe Inflammatory Eye Disease Abstract • Seventeen patients with severe ocular inflammatory disease were treated with intermittent pulse doses of intravenous methylprednisolone. There were five patients with chronic posterior uveitis, five with retinal vasculitis, three with scleritis, two with chronic anterior uveitis, one with pars planitis, and one with Mooren's ulcer. A standard protocol of intravenous administration of methylprednisolone was followed. In 15 of 17 patients receiving this therapy, visual acuity improved or stayed constant. Side effects included psychological disturbances, hypertension, and elevated glucose levels, but cessation of treatment was not necessary in any patient. Pulse methylprednisolone treatment appears to be an effective therapy for several forms of severe inflammatory eye disease and minimizes the potential side effects of more conventional regimens of corticosteroid administration. References 1. Forster PJG, Grindulis KA, Neumann V, et al: High-dose intravenous methylprednisolone in rheumatoid arthritis . Ann Rheum Dis 1982; 41:444-446.Crossref 2. Kimberly RP, Lockshin MD, Sherman RL, et al: High-dose intravenous methylprednisolone pulse therapy in systemic lupus erythematosus . Am J Med 1981;70:817-824.Crossref 3. Cole BR, Brocklebank JT, Kienstra RA, et al: 'Pulse' methylprednisolone therapy in the treatment of severe glomerulonephritis . J Pediatr 1976;88:307-314.Crossref 4. Keogh BA, Bernardo J, Hunninghake GW, et al: Effect of intermittent high dose parenteral corticosteroids on the alveolitis of idiopathic pulmonary fibrosis . Am Rev Respir Dis 1983; 127:18-22. 5. Harrison HL, Linshaw MA, Lindsley CB, et al: Bolus corticosteroids and cyclophosphamide for initial treatment of Wegener's granulomatosis . JAMA 1980;244:1599-1600.Crossref 6. Hogan MJ, Kimura SJ, Thygeson P: Signs and symptoms of uveitis: I. Anterior uveitis . Am J Ophthalmol 1959;152:163-167. 7. Dumonde DC, Kasp-Grochowska E, Graham E, et al: Anti-retinal autoimmunity and circulating immune complexes in patients with retinal vasculitis . Lancet 1982;2:787-792.Crossref 8. Schaller JG: The diversity of JRA: A 1976 look at the subgroups of chronic childhood arthritis . Arthritis Rheum 1977;20( (suppl) ):S52-S61.Crossref 9. Cohen AS, Reynolds WE, Franklin EC, et al: Preliminary criteria for the classification of systemic lupus erythematosus . Bull Rheum Dis 1972;21:643-646. 10. Fauci AS, Wolff SM: Wegener's granulomatosis: Studies in 18 patients and a review of the literature . Medicine 1973;52:535-561.Crossref 11. Mason RM, Barnes CG: Behçet's syndrome with arthritis . Ann Rheum Dis 1969;28:95-103.Crossref 12. Watson PG: Diseases of the sclera and episclera , in Duane TD (ed): Clinical Ophthalmology . New York, Harper & Row Publishers Inc, 1979, vol 4, pp 23-29. 13. Duke-Elder S: The clinical value of cortisone and ACTH in ocular disease: Preliminary assessment for MRC . Br J Ophthalmol 1951; 35:637-642.Crossref 14. Schlaegel TF Jr: Essentials of Uveitis . Boston, Little Brown & Co, 1969, pp 43-48. 15. Favour CB: The cellular response to inflammation and its modification by glucocorticoids , in Mills LC, Moyer JH (eds): Inflammation and Diseases of Connective Tissue . Philadelphia, WB Saunders Co, 1961, pp 486-517. 16. Cupps TR, Fauci AS: Corticosteroid-mediated immunoregulation in man . Immunol Rev 1982;65:133-155.Crossref 17. Peng TF, Yu DTY, Clements PJ, et al: Effect of corticosteroids on the human immune response: Comparison of one and three daily 1-gm intravenous pulses of methylprednisolone . J Lab Clin Med 1978;91:625-634. 18. Melby JC: Clinical pharmacology of systemic corticosteroids . Annu Rev Pharmacol Toxicol 1977;17:511-527.Crossref 19. Hunder GG, Sheps SG, Allen GL, et al: Daily and alternate-day corticosteroid regimens in treatment of giant cell arteritis: Comparison in a prospective study . Ann Intern Med 1975; 82:613-618.Crossref 20. Fessel WJ: Megadose corticosteroid therapy in systemic lupus erythematosus . J Rheumatol 1980;7:486-500. 21. Eyanson S, Passo MH, Aldo-Benson MA, et al: Methylprednisolone pulse therapy for nonrenal lupus erythematosus . Ann Rheum Dis 1980; 34:377-381.Crossref 22. Isenberg DA, Morrow WJ, Snaith ML: Methylprednisolone pulse therapy in the treatment of systemic lupus erythematosus . Ann Rheum Dis 1982;41:347-352.Crossref 23. Stubbs SS, Morrell RM: Intravenous methylprednisolone sodium succinate: Adverse reactions reported in association with immunosuppressive therapy . Transplant Proc 1973;5:1145-1146. 24. Garrett R, Paulus H: Complications of intravenous methylprednisolone pulse therapy , abstracted. Arthritis Rheum 1980;23:677. 25. Suchman AL, Condemi JJ, Leddy JP: Seizure after pulse therapy with methylprednisolone . Arthritis Rheum 1983;26:117.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

Intravenous Pulse Methylprednisolone Therapy in Severe Inflammatory Eye Disease

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Publisher
American Medical Association
Copyright
Copyright © 1986 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.1986.01050180081035
Publisher site
See Article on Publisher Site

Abstract

Abstract • Seventeen patients with severe ocular inflammatory disease were treated with intermittent pulse doses of intravenous methylprednisolone. There were five patients with chronic posterior uveitis, five with retinal vasculitis, three with scleritis, two with chronic anterior uveitis, one with pars planitis, and one with Mooren's ulcer. A standard protocol of intravenous administration of methylprednisolone was followed. In 15 of 17 patients receiving this therapy, visual acuity improved or stayed constant. Side effects included psychological disturbances, hypertension, and elevated glucose levels, but cessation of treatment was not necessary in any patient. Pulse methylprednisolone treatment appears to be an effective therapy for several forms of severe inflammatory eye disease and minimizes the potential side effects of more conventional regimens of corticosteroid administration. References 1. Forster PJG, Grindulis KA, Neumann V, et al: High-dose intravenous methylprednisolone in rheumatoid arthritis . Ann Rheum Dis 1982; 41:444-446.Crossref 2. Kimberly RP, Lockshin MD, Sherman RL, et al: High-dose intravenous methylprednisolone pulse therapy in systemic lupus erythematosus . Am J Med 1981;70:817-824.Crossref 3. Cole BR, Brocklebank JT, Kienstra RA, et al: 'Pulse' methylprednisolone therapy in the treatment of severe glomerulonephritis . J Pediatr 1976;88:307-314.Crossref 4. Keogh BA, Bernardo J, Hunninghake GW, et al: Effect of intermittent high dose parenteral corticosteroids on the alveolitis of idiopathic pulmonary fibrosis . Am Rev Respir Dis 1983; 127:18-22. 5. Harrison HL, Linshaw MA, Lindsley CB, et al: Bolus corticosteroids and cyclophosphamide for initial treatment of Wegener's granulomatosis . JAMA 1980;244:1599-1600.Crossref 6. Hogan MJ, Kimura SJ, Thygeson P: Signs and symptoms of uveitis: I. Anterior uveitis . Am J Ophthalmol 1959;152:163-167. 7. Dumonde DC, Kasp-Grochowska E, Graham E, et al: Anti-retinal autoimmunity and circulating immune complexes in patients with retinal vasculitis . Lancet 1982;2:787-792.Crossref 8. Schaller JG: The diversity of JRA: A 1976 look at the subgroups of chronic childhood arthritis . Arthritis Rheum 1977;20( (suppl) ):S52-S61.Crossref 9. Cohen AS, Reynolds WE, Franklin EC, et al: Preliminary criteria for the classification of systemic lupus erythematosus . Bull Rheum Dis 1972;21:643-646. 10. Fauci AS, Wolff SM: Wegener's granulomatosis: Studies in 18 patients and a review of the literature . Medicine 1973;52:535-561.Crossref 11. Mason RM, Barnes CG: Behçet's syndrome with arthritis . Ann Rheum Dis 1969;28:95-103.Crossref 12. Watson PG: Diseases of the sclera and episclera , in Duane TD (ed): Clinical Ophthalmology . New York, Harper & Row Publishers Inc, 1979, vol 4, pp 23-29. 13. Duke-Elder S: The clinical value of cortisone and ACTH in ocular disease: Preliminary assessment for MRC . Br J Ophthalmol 1951; 35:637-642.Crossref 14. Schlaegel TF Jr: Essentials of Uveitis . Boston, Little Brown & Co, 1969, pp 43-48. 15. Favour CB: The cellular response to inflammation and its modification by glucocorticoids , in Mills LC, Moyer JH (eds): Inflammation and Diseases of Connective Tissue . Philadelphia, WB Saunders Co, 1961, pp 486-517. 16. Cupps TR, Fauci AS: Corticosteroid-mediated immunoregulation in man . Immunol Rev 1982;65:133-155.Crossref 17. Peng TF, Yu DTY, Clements PJ, et al: Effect of corticosteroids on the human immune response: Comparison of one and three daily 1-gm intravenous pulses of methylprednisolone . J Lab Clin Med 1978;91:625-634. 18. Melby JC: Clinical pharmacology of systemic corticosteroids . Annu Rev Pharmacol Toxicol 1977;17:511-527.Crossref 19. Hunder GG, Sheps SG, Allen GL, et al: Daily and alternate-day corticosteroid regimens in treatment of giant cell arteritis: Comparison in a prospective study . Ann Intern Med 1975; 82:613-618.Crossref 20. Fessel WJ: Megadose corticosteroid therapy in systemic lupus erythematosus . J Rheumatol 1980;7:486-500. 21. Eyanson S, Passo MH, Aldo-Benson MA, et al: Methylprednisolone pulse therapy for nonrenal lupus erythematosus . Ann Rheum Dis 1980; 34:377-381.Crossref 22. Isenberg DA, Morrow WJ, Snaith ML: Methylprednisolone pulse therapy in the treatment of systemic lupus erythematosus . Ann Rheum Dis 1982;41:347-352.Crossref 23. Stubbs SS, Morrell RM: Intravenous methylprednisolone sodium succinate: Adverse reactions reported in association with immunosuppressive therapy . Transplant Proc 1973;5:1145-1146. 24. Garrett R, Paulus H: Complications of intravenous methylprednisolone pulse therapy , abstracted. Arthritis Rheum 1980;23:677. 25. Suchman AL, Condemi JJ, Leddy JP: Seizure after pulse therapy with methylprednisolone . Arthritis Rheum 1983;26:117.Crossref

Journal

Archives of OphthalmologyAmerican Medical Association

Published: Jun 1, 1986

References