[Cyclosporin A therapy in severe anterior scleritis. 5 severe courses without verification of associated systemic disease treated with cyclosporin A].
BACKGROUND
Patients with severe scleritis who do not respond to high-dose corticosteroid therapy, or who require a daily corticosteroid maintenance dose higher than 30 mg prednisone should be treated by other immunosuppressants.


METHODS
In five patients with various types of severe anterior scleritis a long-term high-dose steroid treatment failed to control scleral inflammation. They therefore received cyclosporin (CsA). Follow-up was 16-26 months.


RESULTS
Scleral inflammation and ocular complications were controlled in all patients by a regimen of systemic CsA combined with a low maintenance steroid dose below the Cushing threshold. We observed no side effects under CsA serum levels of 120-150 ng/ml. In only one patient was scleral inflammation totally and lastingly eliminated.


CONCLUSIONS
Systemic CsA therapy is of definite therapeutic value in the symptomatic management of steroid refractory severe anterior scleritis without associated systemic disease. Complete healing, however, is achieved only in a minority of cases.
Augenklinik der Heinrich-Heine-Universität Düsseldorf.
J
J
Hillenkamp
A
A
Kersten
C
C
Althaus
R
R
Sundmacher
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016572:Cyclosporine / Q000008:administration & dosage* / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D005260:Female; D005448:Fluocortolone / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D008297:Male; D012008:Recurrence; D015423:Scleritis / Q000188:drug therapy* / Q000209:etiology; D016896:Treatment Outcome
D005448:Fluocortolone; D016572:Cyclosporine