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G.N. Papaliodis, B. Iaccheri, T. Fiore, T. Papadaki, S. Androudi, C. Foster; Cyclosporine and Mycophenolate Mofetil: The Massachusetts Eye and Ear Infirmary Experience in the Treatment of Birdshot Retinochoroidopathy . Invest. Ophthalmol. Vis. Sci. 2003;44(13):2009.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To report the clinical outcomes of patients with birdshot retinochoroidopathy (BSRC) treated with different combinations of cyclosporine (CSA) and mycophenolate mofetil (MFF). Methods: We reviewed the clinical records of 38 patients with BSCR who were treated by us in the period January 2000 to December 2002. Twenty five of 38 patients received one of the following regimens: 1) CSA, 2) MMF, 3) CSA plus MMF. CSA therapy was initiated at 2.5 mg/ kg daily. MFF therapy was started at 1g twice daily. If the inflammation was not controlled with CSA at the maximal dose (5mg/kg/day), MMF was added to the regimen. If the disease was active in patients on MMF therapy at the maximal dose (2.5g/day), CSA was added. The following data were recorded: age, sex, presence of positive HLA A29 haplotype, systemic disease association, previous and current medical treatment, treatment follow-up, and for each therapeutic regimen either initial and final visual acuity, or initial and final level of vitreal inflammation. Results: Twenty-five patients were included in the study. The mean duration of chemotherapy was 33 months (range, 2-114). During the two year period of interest (1/2000 to 12/2002), 17 patients received CSA, 8 received MMF, and 12 were treated with the combination of CSA and MMF. Visual acuity was improved or stable in 87.5% of the eyes treated with CSA plus MMF, 75% of eyes treated with MMF, and 70.6% of eyes treated with CSA. Active inflammation was completely controlled in 100% of eyes treated with combination CSA and MMF, in 70.6% of eyes treated with CSA alone, and in 87.5% of eyes treated with MMF as monotherapy. No side effects were observed in patients on MMF. Four patients on CSA developed minor side effects and one developed hypertension. Nephrotoxic side effects of CSA did not occur. Conclusions: CSA and MMF are effective and safe in the treatment of birdshot chorioretinopathy when used as either monotherapy or in combination.
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