CYCLOSPORINE THERAPY FOR SEVERE SIGHT-THREATENING UVEITIS IN CHILDRENAND ADOLESCENTS

Objective: To review the safety and efficacy of cyclosporine in the tr eatment of children with severe bilateral sight-threatening intermedia te uveitis or panuveitis. Design/Participants: A retrospective chart r eview was performed on all children younger than 18 years of age with chronic bilateral sight-threatening uveitis who were treated with cycl osporine. Main Outcome Measures: Assessment of the therapeutic efficac y and development of adverse effects of cyclosporine after 6 months, 2 years, and 4 years of therapy was performed. Results: Between 1983 an d 1992, 15 children and adolescents were treated with cyclosporine. Af ter 6 months, visual acuity improved or stabilized in 82.1% of eyes, w hile median vitreous inflammation decreased from 2.0 to 0.5. After 2 a nd 4 years, visual acuity improved or stabilized in 64% and 75% of eye s, respectively. Median vitreous inflammation remained 0.5 after 2 and 4 years of therapy. Mean creatinine clearance and hemoglobin values d ecreased and serum creatinine increased after 6 months. After 2 years, only mean hemoglobin values remained decreased. After 4 years, no sig nificant differences were noted in any of the laboratory studies. The most frequently noted side effects included transient increases in ser um creatinine in 53%, gingival hyperplasia in 40%, and hirsutism in 20 % of patients. Conclusions: The authors' results suggest that cyclospo rine is a safe and effective therapy for the treatment of children wit h severe bilateral sight-threatening intermediate uveitis or panuveiti s.