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P. Bhat, F. Anzaar, R. A. Cervantes-Casteñeda, C. S. Foster; Mycophenolate Mofetil in Ocular Sarcoidosis. Invest. Ophthalmol. Vis. Sci. 2007;48(13):3912.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the control of ocular inflammation, steroid sparing effect and incidence of treatment related side-effects in patients with ocular sarcoidosis who were treated with MMF.
Medical records of all patients with a diagnosis of ocular sarcoidosis between 2003 and 2006 were evaluated and those treated with MMF were identified. Previous therapies with steroids, other immunomodulatory therapy, dose and duration of MMF therapy and side effects associated with it were recorded. Remission was defined as trace or absent cells in the anterior and/or posterior segment in the absence of steroid therapy.
We found 7 patients [14 eyes] with ocular sarcoidosis who were treated with MMF. The mean age of presentation in years was 49±23.2. All patients had received oral and/or topical steroids prior to beginning immunomodulatory therapy. Seven eyes had secondary glaucoma [50%] and 6 eyes had cataract [42.85%] as a consequence of steroid use. Five patients had used methotrexate therapy prior to initiation of MMF. The range of methotrexate use was 0.5 to 2 years. All patients were treated only with MMF as the sole immunomodulatory drug. Dosages ranged between 1 to 3 grams daily, the average dose being 2.14± 0.69. The mean duration of drug use was 10± 4.77 months. Three of 7 patients [42.8%] developed leukopenia which necessitated lowering of the dose of the drug and in one patient the drug was discontinued. Five of 14 eyes [35.71%] flared, requiring increase in the dose of the drug and reinitiation of topical steroid. The steroids were then tapered and discontinued. Twelve of the 14 eyes [85.71%] went into remission and 2 of 14 eyes [14.2%] had 1+ cell at the time of data analyses. The mean time to remission was 9.5 months of treatment. The visual acuities in LogMAR, prior to treatment with MMF were OD: 0.43±0.58; OS: 0.62±0.88 and post treatment were OD: 0.31±0.39; OS: 0.39±1.04.
These data suggest that mycophenolate mofetil is an effective agent in the treatment of ocular sarcoidosis, has a corticosteroid sparing effect and a manageable side effect profile.
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