TREATMENT OF OCULAR INFLAMMATORY DISEASE WITH CORTICOSTEROIDS AND CYCLOPHOSPHAMIDE PULSES

The effectiveness, toxicity and prognostic factors influencing respons es to cyclophosphamide (CP) iv pulses plus oral glucocorticosteroids ( GC) in patients with GC-resistant ocular inflammatory diseases (OID) w as evaluated in a cohort of 15 consecutive patients suffering from act ive, non-infectious OID refractory to oral GC. All patients underwent monthly evaluations with clinical, hematological, hepatic, renal and o phthalmologic tests. These included checking visual acuity and both an terior chamber and posterior segment inflammation. The overall effect evaluated by repeated measurements ANOVA demonstrated that after and a verage of 5 CP pulses 1-10, the group showed significant improvement r egarding of visual acuity and inflammation (p<0,000001). Amelioration was not sustained over time in patients with granulomatous uveitis. Pa tients with retinal vasculitis experienced rapid and sustained recover y. By the end of the follow-up period, 53% of the patients had improve d, 20% remained stationary and 26% suffered visual acuity deterioratio n as compared with the baseline. No serious side effects were detected during treatment and follow-up. Conclusions: A combination of oral GC and iv CP pulses appears to be an effective way to treat patients suf fering from noninfectious, non-granulomatous, GC-resistant OID.