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EB Suhler, AR Djalilian, MA Khoshnevisan, SQ Al-Khatib, HN Sen, RB Nussenblatt, RR Buggage; Efficacy Of Mycophenolate Mofetil In Treatment Of Ocular Inflammatory Disease . Invest. Ophthalmol. Vis. Sci. 2002;43(13):4279.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: to assess the efficacy of mycophenolate mofetil (MMF) in the treatment of refractory or severe ocular inflammatory disease. Methods: Case histories of sixteen National Eye Institute patients treated with MMF between October 1998 and August 2001 were reviewed to assess anti-inflammatory and steroid sparing activity, visual acuity outcomes, and side effects in this cohort. Results: Sixteen patients (11 female, 5 male; average age 42.1, range 23-68) were treated for an average of 13.8 months (range 2-34). Diagnoses of patients included idiopathic panuveitis (5), sarcoidosis (3), multiple sclerosis (2), HLA B-27 anterior uveitis (2), idiopathic retinal vasculitis (2), lupus retinal vasculitis (1) and idiopathic intermediate uveitis (1). Ten of fourteen (71.4%) with anterior chamber inflammation in one or both eyes had an improvement in this parameter, 8 of 15 (53.3%) demonstrated improvement in vitreous haze, and 6 of 13 with anterior and posterior inflammation (46.1%) had improvement in both of these parameters. Eight of twelve patients (66.7%) whom were on Prednisone at the onset of the study were able to reduce their Prednisone dose by 50% or more, with two patients able to discontinue Prednisone. Only one of nine (11.1%) patients with cystoid macular edema had resolution of this finding. Six patients (37.5%) had an improvement in visual acuity in one or both eyes of five ETDRS letters (one line) or greater. Reported side effects included upper respiratory infections (six, none requiring hospitalization), headaches (4), skin rashes (2), nausea and/or vomiting, diarrhea (2), dizziness (2), fatigue (2), and palpitations (2). One patient discontinued treament due to fatigue, dizziness, and a syncopal episode, and one patient required dose reduction for hair loss. All other complications were self-limited. Conclusions: MMF is a useful steroid-sparing immunosuppressive agent in selected patients. Further prospective studies are warranted to compare its anti-inflammatory, steroid sparing, and adverse effects to other commonly used immunosuppressive agents.
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