INDICATIONS AND COMPLICATIONS OF SYSTEMIC STEROID-THERAPY IN UVEITIS PATIENTS

Purpose Systemic steroids is often the first choice of immunosuppressi ve therapy for severe endogenous uveitis. The aim of this study was to analyse the indications of steroid therapy, complications and side-ef fects. Patients and methods Charts from all patients that received ora l steroid therapy were reviewed for this purpose and a questionnaire w as sent out to all patients to record their subjective complaints. Res ults From January 1990 to march 1993, 63 out of the 435 new patients s een at the uveitis clinic received oral prednisone. In 4 cases severe complications occurred that did however not lead to discontinuation of therapy. In 2 cases of intolerance ciclosporine (CsA) had to be added to the treatment regimen to lower the steroid dosis and in one case s teroids had to be stopped because of intolerance. The questionnaire sh owed a high rate of subjective side-effects to steroids. Conclusions I n our collective oral steroids were associated with complications, int olerance and side-effects in a high proportion of cases. It is importa nt to explain the possible side-effects to the patient before starting the therapy. The preventable collateral effects like weight gain and de-calcification should be addressed by diet recommendations and moder n calcium sparing therapy.