Abstract
Purpose::
To describe an approach of the care of patients with ocular inflammatory disease resulting in durable remission off medication.
Methods::
Four-hundred and three patients with ocular inflammatory diseases who were treated with immunomodulatory therapy (IMT) at the Massachusetts Eye Research and Surgery Institute (MERSI) were reviewed. Fifty patients with a minimum of 12 months free of inflammation off medication were identified.
Results::
Among 50 patients in durable remission, 56% were females and 44% were males. Mean age was 46 years (standard deviation 22.5, range 10-88). Ocular diagnoses were: idiopathic anterior uveitis in 10 patients, juvenile idiopathic arthritis associated iridocyclitis in 6, birdshot choroidoretinopathy in 4, ocular cicatricial pemphigoid in 4, idiopathic pars planitis and miscellaneous 22. Methotrexate was the most used drug; 52% of the patients had methotrexate at any giving time and 32% had methotrexate as monotherapy during the full treatment period. Fifteen percent of the patients required 2 years or less of medication to obtain durable remission, and 44% required IMT between 2 and 5 years to achieve remission off medication. Twenty percent had been free of inflammation 2 to 5 years, and 18% for more than 5 years after discontinuation of IMT. Mean visual acuity was 20/23 in both eyes, 88% (44 patients) had 20/20 vision in the better seeing eye.
Conclusions::
Durable remission for patients with ocular inflammation is an achievable goal and one which we believe most ocular inflammatory disease specialist, pursue.
Keywords: uveitis-clinical/animal model • immunomodulation/immunoregulation