Purchase this article with an account.
C.H. Lau, M. Comer, S. Lightman; Effect of Systemic Immunosuppression on the Long-term Visual Outcome of Ocular Behçet’s Disease . Invest. Ophthalmol. Vis. Sci. 2003;44(13):2415.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Purpose: To assess the effect of systemic immunosuppression on the long-term visual outcome of ocular Behçet’s disease. Methods: Open-label, comparative, retrospective series. Forty-six ocular Behçet’s disease patients were treated with systemic corticosteroids. 37 were treated with additional second-line immunosuppressive agents and 9 had corticosteroids alone. Indications for second-line immunosuppressive agents included steroid reduction, failure of steroid to control inflammation, drug toxicity or lack of efficacy. Visual acuity, control of ocular inflammation, side-effects and toxicity of drugs were monitored. Results: Visual acuity was maintained or improved in 62% of patients and the mean visual acuity reduction was about one Snellen line for the whole group over a mean interval of more than eight and half years. The reduction of the mean VA occurred mainly after five years of follow up. Visual outcomes were better in patients presenting with VA < 20/40 or who were given second-line immunosuppressive treatment in addition to steroids, but were less satisfactory with good vision at presentation (VA ≥ 20/40) or when second-line immunosuppressive treatment was not used. Conclusions: Second-line immunosuppressive agents are beneficial to the visual outcome in ocular Behçet’s disease up to 5 years after which some deterioration still occurs. There was no difference in efficacy between cyclosporine and azathioprine in the long term visual outcome. Methotrexate and mycophenolate mofetil are useful in stabilizing poor visual acuity on presentation or when other treatment fails.
This PDF is available to Subscribers Only