Long-term immunosuppressive treatment of serpiginous choroiditis.
OBJECTIVE
To determine the efficacy of immunosuppressive treatment in serpiginous choroiditis.


METHODS
The clinical courses were reviewed of six consecutive patients (12 eyes) with vision-threatening, steroid-dependent/resistant serpiginous choroiditis treated with a combination of immunosuppressive agents including azathioprine, cyclosporine, and cyclophosphamide. All patients underwent treatment for at least 12 months.


RESULTS
The follow-up period ranged from 17 to 105 months (mean 57, median 43). All patients were able to taper oral steroids. Five patients discontinued all immunosuppressive medications after a treatment period of 12 to 69 months (mean 39 months). Immunosuppressive treatment was continued in one patient at a "low" maintenance dose. Ten eyes had improved visual acuities, while vision remained impaired in two due to macular scars. Recurrence was noted in two patients when an attempt was made to decrease the dose of immunosuppressive medication. Two patients experienced side effects which were reversed by decreasing the dose of the medications.


CONCLUSIONS
Long-term immunosuppressive treatment appears to prolong remission and preserve vision in patients with serpiginous choroiditis.
Akpek
E K
EK
Ocular Immunology & Uveitis Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA 02114, USA.
Baltatzis
S
S
Yang
J
J
Foster
C S
CS
D000328:Adult; D000368:Aged; D001379:Azathioprine / Q000627:therapeutic use*; D002833:Choroiditis / Q000175:diagnosis / Q000188:drug therapy*; D003520:Cyclophosphamide / Q000627:therapeutic use*; D016572:Cyclosporine / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007208:Indocyanine Green; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D016896:Treatment Outcome; D014792:Visual Acuity
D007166:Immunosuppressive Agents; D016572:Cyclosporine; D003520:Cyclophosphamide; D007208:Indocyanine Green; D001379:Azathioprine