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N.N. Patel, C. Radhakrishnan, T. Krupin, L. Farrokh–Siar; Subconjunctival 5–Flourouracil for Anterior Uveitis . Invest. Ophthalmol. Vis. Sci. 2006;47(13):2426.
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To evaluate efficacy and safety of subconjunctival 5–fluorouracil (5–FU) to treat anterior uveitis
Six patients with documented anterior uveitis were analyzed to evaluate treatment of uveitis with conjunctival 5–FU injection. 5mg of 5–FU was injected in the inferior bulbar conjunctiva. Patients were evaluated and given 5–FU injections by two treating physicians. Degree of anterior chamber inflammation, visual acuity, intraocular pressure, mean number of injections and mean time to recovery were all recorded. Patients were excluded if they had not completed a follow–up examination after the 5–FU was administered or if they had any procedures performed within one month of receiving the 5–FU injection. Outcome measures were documented decrease in inflammation and improvement of visual acuity.
6/6 patients showed improvement or stabilization of anterior chamber inflammation after a subconjunctival 5–FU injection. Vision improved in 4/6 patients. Mean time to decrease in anterior chamber inflammation was 1.6 months. Mean number of injections was 1.75. There were no deleterious side effects from the injection such as bleeding, pain, or infection.
5–FU has been shown to be effective after uveitic glaucoma surgery to decrease scarring post–trabeculectomy as well as stablizing inflammation. For this reason it is proposed to use 5–FU as an inflammatory mediator in treatment of anterior uveitis. 5–FU is an inhibitor of thymidylate synthase thus leading to inhibition of DNA synthesis and decreasing inflammatory cell production. The process is not immediate and may require multiple treatments. It is a useful tool as an adjunct to topical steroids. It is especially useful in cases where patients have not responded to conventional treatment or are steroid responders. 5–FU is shown by this data to be a safe and efficacious treatment for anterior uveitis.
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