The rapeutic Effects of Low Dose Triple Agents [Steroid, Cyclosporine and Azathiprine]on Refractory Uveitis.

Choi, Yeun Kyoung; Kim, Min Ho; Yoo, Jin Sung; Huh, Warne

Original Article

Journal of the Korean Ophthalmological Society 2000;41(3):660-667.
Published online March 1, 2000.

The rapeutic Effects of Low Dose Triple Agents [Steroid, Cyclosporine and Azathiprine]on Refractory Uveitis.

Yeun Kyoung Choi, Min Ho Kim, Jin Sung Yoo, Warne Huh

Department of Ophthalmology, Kangnam St.Mary's Hospital, College of Medicine, The Catholic University of Korea.

난치성 포도막염에서 Steroid , Cyclosporine , Azathioprine 병합치료 효과

김민호(Min Ho Kim),유진성(Jin Seong Yoo),허원(Warne Huh),최연경(Yeun Kyoung Choi)

Abstract

Immunosuppressive agent has been used as a therapeutic agent for Endogeneous posterior uveitis[EPU]. But serious side effect of steriod or cyclosporine and frequent recurrence of ocular inflammation warrant the addition of other immunosuppressive agents. In this study, we evaluated the therapeutic effectiveness of low dose triple therapy using steroid, cyclosporine and azathioprine when combination therapy with steroid and cyclosporine had failed. We reviewed the records of 10 Behcet's patients[18 eyes]and 2 sympathetic ophthalmia patients[2 eyes]who had been resistant to steroid and cyclosporine combination therapy. The median follow up duration of triple therapy was 16.3 months. Recurrence, severity of inflammation, systemic manifestations associated with Behcet's disease, and side effect of therapeutic agents were evaluated. There was a significantly decrease in the frequency[0.37/month during pretriple therapy and 0.14/month after triple therapy]and severity of ocular inflammation[p<0.01]. The frequency and severity of systemic manifestations also decreased. Visual acuity remained stable in 7 eyes[35%]and improved in 13 eyes[65%]. No serious side effects or newly developed side effect were developed during triple therapy except reversible mild anemia in 1 patient. The results of our study suggest that triple agent immunosuppressive therapy is well tolerated and appears to be effective for the severe uveitis which is refraction to steroid and cyclosporine combination therapy.

Key Words: Endogenous posterior uveitis [EPU];Immunosuppressive agent;Triple therapy