Immunosuppressive treatment of choroidal neovascularization associated with endogenous posterior uveitis

Arch Ophthalmol. 1998 Nov;116(11):1456-61. doi: 10.1001/archopht.116.11.1456.

Abstract

Objective: To determine whether resolution of choroidal neovascularization (CNV), a recognized sight-threatening complication of endogenous posterior uveitis, and maintenance of vision could be achieved with immunosuppression.

Patients and methods: Fourteen patients (17 eyes) with CNV associated with endogenous posterior uveitis were enrolled in an open study. Ages ranged from 5 to 51 years. Three eyes had extrafoveal CNV, 6 juxtafoveal, and 8 subfoveal. Three patients were treated with a single course of oral corticosteroids, 2 had additional cyclosporine for up to 2 years, and 9 continued to receive a low-dose regimen of a combination of immunosuppressive drugs.

Results: After a median follow-up of 15 months (range, 7 months to 6 1/2 years), 9 of 17 eyes had an improvement in visual acuity; 6 remained within 1 Snellen line of initial visual acuity, and 2 had lost 2 Snellen lines. Angiographically, CNV resolved in 13 eyes, resolved then recurred in 3, and improved but persisted in 4.

Conclusion: These results support a role for immunosuppressive therapy in the treatment of CNV associated with endogenous posterior uveitis.

MeSH terms

  • Adolescent
  • Adult
  • Azathioprine / adverse effects
  • Azathioprine / therapeutic use
  • Child
  • Child, Preschool
  • Choroidal Neovascularization / drug therapy*
  • Choroidal Neovascularization / etiology
  • Cyclosporine / adverse effects
  • Cyclosporine / therapeutic use
  • Drug Therapy, Combination
  • Female
  • Fluorescein Angiography
  • Follow-Up Studies
  • Fundus Oculi
  • Humans
  • Immunosuppressive Agents / adverse effects
  • Immunosuppressive Agents / therapeutic use*
  • Male
  • Middle Aged
  • Prednisolone / adverse effects
  • Prednisolone / analogs & derivatives
  • Prednisolone / therapeutic use
  • Treatment Outcome
  • Uveitis, Posterior / complications*
  • Visual Acuity

Substances

  • Immunosuppressive Agents
  • Cyclosporine
  • prednisolone acetate
  • Prednisolone
  • Azathioprine