title: Mycophenolic acid in the treatment of birdshot chorioretinopathy: long-term follow-up.
abstract: OBJECTIVE
  To assess the long-term efficacy and tolerability of both derivatives of mycophenolic acid, mycophenolate mofetil (MMF) and mycophenolate sodium (MPS), in the therapy of patients with birdshot chorioretinopathy (BSCR).
  
  
  METHODS
  Retrospective analysis of 24 patients (48 eyes) with BSCR, treated with MMF or MPS with a follow-up of at least 1 year. The main outcome measures included control of inflammation, steroid-sparing potential and side effects. Secondary outcome measure was the development of retinal function during the therapy measured by best-corrected visual acuity (BCVA), visual field and/or electroretinography (ERG).
  
  
  RESULTS
  Twelve patients (50%) were treated with MMF and 12 patients (50%) with MPS. Control of intraocular inflammation, defined as complete lack of clinical and angiographic signs of inflammatory activity, was achieved in 16 of 24 patients (67%). The angiographic signs of activity were significantly reduced during the follow-up (p<0.05). No significant difference was found in the mean BCVA, the visual field and the ERG parameters during the treatment compared with the baseline (p>0.05). In 20 out of 21 patients (95%) who received systemic corticosteroids, the corticosteroids could be tapered to a daily dose of ≤10 mg (rate 0.26/patient-year). Drug-related side effects occurred in 12 patients (50%, rate 0.16/patient-year). In four patients (17%), a therapy switch from MMF to MPS was undertaken due to gastrointestinal discomfort.
  
  
  CONCLUSIONS
  Derivatives of mycophenolic acid are effective and safe drugs for the treatment of BSCR. In cases with gastrointestinal side effects, a therapy switch from MMF to MPS should be considered.
authors: Centre for Ophthalmology, University of Tuebingen, Tuebingen, Germany.
authors: Deshka
authors: D
authors: Doycheva
authors: Centre for Ophthalmology, University of Tuebingen, Tuebingen, Germany Department of Ophthalmology, University of Regensburg, Regensburg, Germany.
authors: Herbert
authors: H
authors: Jägle
authors: Centre for Ophthalmology, University of Tuebingen, Tuebingen, Germany.
authors: Manfred
authors: M
authors: Zierhut
authors: Centre for Ophthalmology, University of Tuebingen, Tuebingen, Germany.
authors: Christoph
authors: C
authors: Deuter
authors: Department of Clinical Epidemiology and Applied Biometry, University of Tuebingen, Tuebingen, Germany.
authors: Gunnar
authors: G
authors: Blumenstock
authors: Centre for Ophthalmology, University of Tuebingen, Tuebingen, Germany Competence Center "Vision Research", Study Course "Ophthalmic Optics/Audiology", University of Applied Sciences, Aalen, Germany.
authors: Ulrich
authors: U
authors: Schiefer
authors: Centre for Ophthalmology, University of Tuebingen, Tuebingen, Germany.
authors: Katarina
authors: K
authors: Stingl
authors: Centre for Ophthalmology, University of Tuebingen, Tuebingen, Germany.
authors: Kai
authors: K
authors: Januschowski
authors: Centre for Ophthalmology, University of Tuebingen, Tuebingen, Germany.
authors: Bogomil
authors: B
authors: Voykov
authors: Department of Ophthalmology, Charité, University Medicine Berlin, Berlin, Germany.
authors: Nicole
authors: N
authors: Stuebiger
mesh_terms: D000328:Adult; D000368:Aged; D000080365:Birdshot Chorioretinopathy; D002825:Chorioretinitis / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D004596:Electroretinography; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D012160:Retina / Q000503:physiopathology; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D014794:Visual Fields / Q000502:physiology
chemical_list: D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid
keywords: Inflammation