Clinical outcome of patients treated with sirolimus
Case No | Snellen visual acuity pretreatment | Snellen visual acuity post-treatment | Intraocular inflammation BIO score RE/LE pretreatment | Intraocular inflammation BIO score RE/LE post-treatment | Pretreatment prednisolone dose/current prednisolone dose | Clinical outcome | ||
---|---|---|---|---|---|---|---|---|
BIO, binocular indirect score; CMO, cystoid macular oedema; HM, hand movements; IV MP, intravenous methylprednisolone. | ||||||||
1 | 6/6, 6/9 | 6/5+3, 6/6+3 | 0 1 | 1 2 | 40 mg/10 mg | Treatment failure | ||
Initial control of inflammation followed by relapse on tapering treatment requiring higher doses of sirolimus with intolerable side effects | ||||||||
Current medication: tacrolimus, prednisolone and sirolimus | ||||||||
2 | 6/18, 6/12 | 6/9, 6/9 | 3 3 | 0 0 | 40 mg/6 mg | Symptom improvement: reduction of floaters | ||
3 | 6/36, 6/4 | 6/36, 6/4 | 1 0 | 0 0 | Intermittent IV MP/0 mg | Symptom improvement: reduction in pain and photophobia | ||
4 | 6/6+1, 6/12 | 6/5−1, 6/9 | 1 1 | 0 0 | 30 mg/0 mg | Reduction in vasculitis and regression of neovascularisation | ||
5 | 1/60, 6/18 | 1/60, 6/9 | 1 2 | 0 0 | 40 mg/15 mg | Treatment failure | ||
Despite reduction of inflammation mild CMO persists. Treatment withdrawn due to side effects | ||||||||
Current medication: tacrolimus and oral corticosteroids | ||||||||
6 | 6/5, 6/9 | 6/5, 6/5 | 0 2 | 0 0 | 50 mg reducing to 20 mg/0 mg | Symptom improvement: reduction in pain | ||
Regression of vasculitis with no further flare ups | ||||||||
7 | 6/18, HM | 6/18, HM | 0 0 | 0 0 | 15 mg/7.5 mg | Marked improvement in systemic symptoms of Behçet’s syndrome | ||
Regression of vasculitis with no further flare ups | ||||||||
8 | HM, 6/12 | HM, 6/12 | 2 2 | 1 1 | Intermittent IV MP/6 mg and pulsed IV MP | Treatment failure | ||
Continuing episodes of vasculitis leading to transient vision loss requiring repeated IV MP | ||||||||
Currently on tacrolimus, prednisolone, and sirolimus |