Retina-Vitreous
2009 , Vol 17 , Num 4
Immunosuppression Therapy in Multifocal Choroiditis and Panuveitis
S.B. Ankara Eğitim ve Araştırma Hastanesi, 1. Göz Kliniği, Ankara, Uzm. Dr.
Purpose: To evaluate the visual prognosis, ocular complications and the efficacy of the immunusuppressive drug treatment in the multifocal choroiditis and panuveitis (MFCP).Materials and Methods: Twenty-seven eyes of 14 patients with MFCP who were admitted to the Uvea-Behçet Service between January 1997-January 2007 were included in this retrospective study. Complete blood count, urine analysis, sedimantation rate, chest X-ray, and tests including syphilis, sarcoidosis, tuberculosis, brucellosis and toxoplasmosis were carried out. The visual acuity and intraocular pressure measurements, and biomicroscopic anterior segment, vitreous and fundus examinations were performed. Also fundus fluorecein angiography was obtained in some patients.
Results: Age at the beginning of MFCP was 39.9±10.5 (25- 66), and ratio of male/female was ¾. The ocular involvement was bilateral in all patients. Mean follow-up period was 4.3±3.1 (1-11) years. While the mean best corrected visual acuity obtained from Snellen chart after conversion to logMar equivalent, at first admission was 0.58±0.63 (0.0-2.1), visual acuity at last visit during inactive phase of disease was 0.30±0.49 (0.0-2.1). Visual acuity at last visit was higher than the visual acuity at first admission (p=0.002). During the follow-up period 22 eyes (%81.5) had cystoid macular edema, 2 eyes (%7.4) choroidal neovascular membrane (CNVM), 15 eyes (%55.6) had glaucoma and 10 eyes (%37.0) had cataract. Eleven patients were given a combination therapy of oral corticosteroid, azatyoprine and cylosporine A. One patient received oral corticosteroid, azatyoprine and cylosporine A, and 2 patients received oral corticosteroid and cylosporine A.
Conclusions: Immunusuppressive drugs suppress inflammmation adequately in MFCP patients. They have useful effects in visual prognosis and they decrease the ratio of development of CNVM. Keywords : Azothioprine, choridal neovascular membrane, cyclosporine-A, cystoid macular edema, multifocal choroiditis and panuveitis