Abstract
Abstract: :
Purpose: This study is aimed at determining the safety and efficacy of intravenous pulse cyclophosphamide therapy in ocular inflammatory disease. Method: The records of thirty consecutive patients treated with intravenous pulse cyclophosphamide at the Massachusetts Eye & Ear Infirmary between January 1995 and April 2001 were reviewed. Frequencies of adverse reactions and control of ocular inflammation were determined. Main outcome measures included incidence of adverse reactions during therapy, complications during follow up, as well as maintenance of remission. Results: Thirty patients were treated with intravenous pulse cyclophosphamide during the study period. Nine were treated for necrotizing scleritis, 5 for scleritis, 4 for panuveitis, 3 for ocular cicatricial pemphigoid, 3 for anterior uveitis, 2 for peripheral ulcerative keratitis, 2 for retinal vasculitis, and and one for sclerosing inflammatory pseudotumor. Remission of ocular inflammation was maintained in 15 (50%). Most common adverse effects during treatment were fatigue (40% of patients), nausea (23.3%), upper respiratory tract infection (23.3%), rash (20%), and headache (20%). The major complications of hemorrhagic cystitis and malignancy, did not occur during treatment or the follow up period. Conclusion: Intravenous pulse cyclophosphamide can be a safe and effective alternative for managing recalcitrant ocular inflammatory disease of diverse etiologies.
Keywords: 435 immunomodulation/immunoregulation • 611 uvea • 357 clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials