Letters 1. John GT, Manivannan J, Chandy S, et al. A prospective evaluation of macular edema, thought to be immune recovery uveitis in the leflunomide therapy for cytomegalovirus disease in renal transplant recipients. absence of CMV retinitis. She was treated with topical steroid Transplant Proc. 2005;37(10):4303-4305. eyedrops twice daily, an increased prednisone dosage to 60 2. Waldman WJ, Knight DA, Lurain NS, et al. Novel mechanism of inhibition of mg/d, and an increased leflunomide dosage to 60 mg/d. cytomegalovirus by the experimental immunosuppressive agent leflunomide. In April 2007, she developed an acute decrease in visual Transplantation. 1999;68(6):814-825. acuity of the right eye without floaters or pain. Her visual acu- 3. Avery RK, Mossad SB, Poggio E, et al. Utility of leflunomide in the treatment of complex cytomegalovirus syndromes. Transplantation. 2010;90(4):419-426. ity without correction was 20/200 OD. Optical coherence to- mography demonstrated an increase in macular edema on the 4. Levi ME, Mandava N, Chan LK, Weinberg A, Olson JL. Treatment of multidrug-resistant cytomegalovirus retinitis with systemically administered right. The leflunomide dosage was increased to 80 mg/d and leflunomide. Transpl Infect Dis. 2006;8(1):38-43. eventually 100 mg/d without improvement in macular edema, 5. Kuo IC, Imai Y, Shum C, Martin DF,
JAMA Ophthalmology – American Medical Association
Published: Jul 1, 2013
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