Cyclosporine therapy for severe sight-threatening uveitis in children and adolescents.
OBJECTIVE
To review the safety and efficacy of cyclosporine in the treatment of children with severe bilateral sight-threatening intermediate uveitis or panuveitis.


METHODS
A retrospective chart review was performed on all children younger than 18 years of age with chronic bilateral sight-threatening uveitis who were treated with cyclosporine.


METHODS
Assessment of the therapeutic efficacy and development of adverse effects of cyclosporine after 6 months, 2 years, and 4 years of therapy was performed.


RESULTS
Between 1983 and 1992, 15 children and adolescents were treated with cyclosporine. After 6 months, visual acuity improved or stabilized in 82.1% of eyes, while median vitreous inflammation decreased from 2.0 to 0.5. After 2 and 4 years, visual acuity improved or stabilized in 64% and 75% of eyes, respectively. Median vitreous inflammation remained 0.5 after 2 and 4 years of therapy. Mean creatinine clearance and hemoglobin values decreased and serum creatinine increased after 6 months. After 2 years, only mean hemoglobin values remained decreased. After 4 years, no significant differences were noted in any of the laboratory studies. The most frequently noted side effects included transient increases in serum creatinine in 53%, gingival hyperplasia in 40%, and hirsutism in 20% of patients.


CONCLUSIONS
The authors' results suggest that cyclosporine is a safe and effective therapy for the treatment of children with severe bilateral sight-threatening intermediate uveitis or panuveitis.
Walton
R C
RC
Clinical Branch, National Eye Institute, National Institutes of Health, Bethesda, Maryland, USA.
Nussenblatt
R B
RB
Whitcup
S M
SM
D000293:Adolescent; D002648:Child; D003404:Creatinine / Q000097:blood; D016572:Cyclosporine / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D015864:Panuveitis / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D012189:Retrospective Studies; D012449:Safety; D016896:Treatment Outcome; D015867:Uveitis, Intermediate / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D014786:Vision Disorders / Q000097:blood / Q000209:etiology; D014792:Visual Acuity
D007166:Immunosuppressive Agents; D016572:Cyclosporine; D003404:Creatinine