Skip to main content
PMC home page
The British Journal of Ophthalmology logoLink to The British Journal of Ophthalmology
. 1990 Jun;74(6):344–349. doi: 10.1136/bjo.74.6.344

Cyclosporin in the treatment of severe chronic idiopathic uveitis.

J de Vries 1, G S Baarsma 1, M J Zaal 1, T N Boen-Tan 1, A Rothova 1, H J Buitenhuis 1, C M Schweitzer 1, R J de Keizer 1, A Kijlstra 1
PMCID: PMC1042124  PMID: 2198928

Abstract

In a randomised double-masked study of 27 patients with a severe chronic idiopathic uveitis we evaluated the efficacy, safety, and tolerability of cyclosporin. All received prednisone in a low dose (0.3 mg/kg/day). In 14 patients this was combined with cyclosporin in a single daily dose of 10 mg/kg/day, while 13 patients received a placebo. The dosages were tapered off in accordance with a protocol, and we compared the number of months of successful therapy before the uveitis relapsed. The efficacy results, as expressed in a Kaplan-Meier curve, were in favour of cyclosporin. Owing to the small sample size, however, this difference did not reach statistical significance. The immunosuppressive effect of cyclosporin was not permanent, and in all but one patient the intraocular inflammation relapsed on reduction of dosage. Rather small cumulative doses of cyclosporin proved to be nephrotoxic, but subjective tolerability for cyclosporin was good.

Full text

PDF
345

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Benezra D., Cohen E. Treatment and visual prognosis in Behçet's disease. Br J Ophthalmol. 1986 Aug;70(8):589–592. doi: 10.1136/bjo.70.8.589. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Cockcroft D. W., Gault M. H. Prediction of creatinine clearance from serum creatinine. Nephron. 1976;16(1):31–41. doi: 10.1159/000180580. [DOI] [PubMed] [Google Scholar]
  3. Deeg H. J., Storb R., Gerhard-Miller L., Shulman H. M., Weiden P. L., Thomas E. D. Cyclosporin A, a powerful immunosuppressant in vivo and in vitro in the dog, fails to induce tolerance. Transplantation. 1980 Mar;29(3):230–235. doi: 10.1097/00007890-198003000-00014. [DOI] [PubMed] [Google Scholar]
  4. Fite K. V., Pardue S., Bengston L., Hayden D., Smyth J. R., Jr Effects of cyclosporine in spontaneous, posterior uveitis. Curr Eye Res. 1986 Oct;5(10):787–796. doi: 10.3109/02713688609000020. [DOI] [PubMed] [Google Scholar]
  5. Frey F. J., Schnetzer A., Horber F. F., Frey B. M. Evidence that cyclosporine does not affect the metabolism of prednisolone after renal transplantation. Transplantation. 1987 Apr;43(4):494–498. doi: 10.1097/00007890-198704000-00007. [DOI] [PubMed] [Google Scholar]
  6. Graham E. M., Sanders M. D., James D. G., Hamblin A., Kasp Grochowska E., Dumonde D. Cyclosporin A in the treatment of posterior uveitis. Trans Ophthalmol Soc U K. 1985;104(Pt 2):146–151. [PubMed] [Google Scholar]
  7. HOGAN M. J., KIMURA S. J., THYGESON P. Signs and symptoms of uveitis. I. Anterior uveitis. Am J Ophthalmol. 1959 May;47(5 Pt 2):155–170. doi: 10.1016/s0002-9394(14)78239-x. [DOI] [PubMed] [Google Scholar]
  8. Henderly D. E., Genstler A. J., Smith R. E., Rao N. A. Changing patterns of uveitis. Am J Ophthalmol. 1987 Feb 15;103(2):131–136. doi: 10.1016/s0002-9394(14)74217-5. [DOI] [PubMed] [Google Scholar]
  9. Johnston A., Marsden J. T., Holt D. W. The United Kingdom Cyclosporin Quality Assessment Scheme. Ther Drug Monit. 1986;8(2):200–204. doi: 10.1097/00007691-198606000-00013. [DOI] [PubMed] [Google Scholar]
  10. Langhoff E., Madsen S., Flachs H., Olgaard K., Ladefoged J., Hvidberg E. F. Inhibition of prednisolone metabolism by cyclosporine in kidney-transplanted patients. Transplantation. 1985 Jan;39(1):107–109. [PubMed] [Google Scholar]
  11. Lubin J. R., Albert D. M., Weinstein M. Sixty-five years of sympathetic ophthalmia. A clinicopathologic review of 105 cases (1913--1978). Ophthalmology. 1980 Feb;87(2):109–121. doi: 10.1016/s0161-6420(80)35270-6. [DOI] [PubMed] [Google Scholar]
  12. Mochizuki M., Nussenblatt R. B., Kuwabara T., Gery I. Effects of cyclosporine and other immunosuppressive drugs on experimental autoimmune uveoretinitis in rats. Invest Ophthalmol Vis Sci. 1985 Feb;26(2):226–232. [PubMed] [Google Scholar]
  13. Myers B. D. Cyclosporine nephrotoxicity. Kidney Int. 1986 Dec;30(6):964–974. doi: 10.1038/ki.1986.280. [DOI] [PubMed] [Google Scholar]
  14. Müftüoğlu A. U., Pazarli H., Yurdakul S., Yazici H., Ulkü B. Y., Tüzün Y., Serdaroğlu S., Altuğ E., Bahçecioğlu H., Güngen G. Short term cyclosporin A treatment of Behçet's disease. Br J Ophthalmol. 1987 May;71(5):387–390. doi: 10.1136/bjo.71.5.387. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Nissen C., Bendtzen K., Tvede N., Andersen V. The treatment of presumed non-infective uveitis with cyclosporin A. Acta Ophthalmol Suppl. 1985;173:72–73. doi: 10.1111/j.1755-3768.1985.tb06845.x. [DOI] [PubMed] [Google Scholar]
  16. Nussenblatt R. B., Palestine A. G., Chan C. C. Cyclosporin A therapy in the treatment of intraocular inflammatory disease resistant to systemic corticosteroids and cytotoxic agents. Am J Ophthalmol. 1983 Sep;96(3):275–282. doi: 10.1016/s0002-9394(14)77814-6. [DOI] [PubMed] [Google Scholar]
  17. Nussenblatt R. B., Palestine A. G., Chan C. C., Mochizuki M., Yancey K. Effectiveness of cyclosporin therapy for Behçet's disease. Arthritis Rheum. 1985 Jun;28(6):671–679. doi: 10.1002/art.1780280611. [DOI] [PubMed] [Google Scholar]
  18. Nussenblatt R. B., Rodrigues M. M., Salinas-Carmona M. C., Gery I., Cevario S., Wacker W. Modulation of experimental autoimmune uveitis with cyclosporin A. Arch Ophthalmol. 1982 Jul;100(7):1146–1149. doi: 10.1001/archopht.1982.01030040124022. [DOI] [PubMed] [Google Scholar]
  19. Ost L. Effects of cyclosporin on prednisolone metabolism. Lancet. 1984 Feb 25;1(8374):451–451. doi: 10.1016/s0140-6736(84)91778-1. [DOI] [PubMed] [Google Scholar]
  20. Palestine A. G., Austin H. A., 3rd, Balow J. E., Antonovych T. T., Sabnis S. G., Preuss H. G., Nussenblatt R. B. Renal histopathologic alterations in patients treated with cyclosporine for uveitis. N Engl J Med. 1986 May 15;314(20):1293–1298. doi: 10.1056/NEJM198605153142005. [DOI] [PubMed] [Google Scholar]
  21. Palestine A. G., Nussenblatt R. B., Chan C. C. Side effects of systemic cyclosporine in patients not undergoing transplantation. Am J Med. 1984 Oct;77(4):652–656. doi: 10.1016/0002-9343(84)90356-5. [DOI] [PubMed] [Google Scholar]
  22. Quentin C. D., Vogel M. Ciclosporin-Behandlung bei Uveitis. Klin Monbl Augenheilkd. 1986 Mar;188(3):248–250. doi: 10.1055/s-2008-1050623. [DOI] [PubMed] [Google Scholar]
  23. Ringdén O. Cyclosporine in allogeneic bone marrow transplantation. Transplantation. 1986 Nov;42(5):445–452. doi: 10.1097/00007890-198611000-00001. [DOI] [PubMed] [Google Scholar]
  24. Schulak J. A., Monson D., Shelby J., Corry R. J. Abrogation of second-set rejection with cyclosporine. Transplantation. 1983 Sep;36(3):289–293. doi: 10.1097/00007890-198309000-00012. [DOI] [PubMed] [Google Scholar]
  25. Striph G., Doft B., Rabin B., Johnson B. Retina S antigen-induced uveitis. The efficacy of cyclosporine and corticosteroids in treatment. Arch Ophthalmol. 1986 Jan;104(1):114–117. doi: 10.1001/archopht.1986.01050130128036. [DOI] [PubMed] [Google Scholar]
  26. Svenson K., Bohman S. O., Hällgren R. Renal interstitial fibrosis and vascular changes. Occurrence in patients with autoimmune diseases treated with cyclosporine. Arch Intern Med. 1986 Oct;146(10):2007–2010. [PubMed] [Google Scholar]

Articles from The British Journal of Ophthalmology are provided here courtesy of BMJ Publishing Group

RESOURCES