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R. Azni Aziz, N. Ngah; Outcome of Immunosuppressive Treatment in Patients With Non Infective Posterior Uveitis: A Retrospective Analysis. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5138.
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Steroid sparing immunosuppressive agents have been used to manage uveitic cases where corticosteroid therapy alone does not provide adequate control or causes undesirable side effects. Mycophenolate mofetil (MMF), an effective immunosuppressant in the control of intraocular inflammation with potentially minimal side effects, is usually the first line of steroid sparing agent used. This study evaluates the outcomes of patients with various forms of chronic non infective posterior uveitis treated with MMF and other immunosuppressive agents.
Non comparative retrospective analysis was done on patients with non infective posterior uveitis on treatment with MMF who attended the medical retina unit, Ophthalmology department, Hospital Selayang. Case notes of 18 patients with non infective posterior uveitis treated with MMF and other steroid sparing immunosuppressives were reviewed. Main outcome measures were visual acuity, duration of quiescent period, recurrence rate and time to initial response.
7 patients with Vogt Koyanagi Harada’s disease, 3 patients with Behcet’s disease, 3 patients with Sarcoidosis, 3 patients with Intermediate Uveitis, 1 patient with Sympathetic Ophthalmitis and 1 Idiopathic Pan Uveitis. Steroid sparing effect was achieved in all patients. Average duration of follow up was 15.5 months Visual acuity remained stable and improved in 76% of eyes. The period of quiescence ranged from 3 months to 20 months with a min period of 11.6 months. The recurrence rate was notably reduced in patients treated with MMF compared to patients treated with other immunosuppressive agents. Time to initial response to these steroid sparing immunosuppressive agents ranged from 2 to 6 weeks.
Second line immunosuppressive agents are beneficial in the treatment of non infective posterior uveitis, helps reduce the side effects of corticosteroid and maintain an acceptable period of quiescence.
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