Cyclosporin-A Therapy in Severe Uveitis of Behcet's Disease

Abstract

Purpose: Cyclosporine-A (CSA) combined with corticosteroid therapy was administered to 12 patients with severe Behcet's uveitis who were resistant to colchicine or cytotoxic therapy. Methods: Previous colchicine or cytotoxic therapies were tapered off one month before CSA therapy All patients were started on an initial oral dose: of 5 mg/kg/day of CSA. After the first three months, the CSA dose was reduced to a maintenance dose according to the intraocular inflammatory response. Results: The average follow-up period was 20 (12-36) months. Visual acuity remained the same in 12 (%54.5) and improved in 8 (%36.4) eyes. There was a decrease in the frequency (p < 0.01) and severity (p < 0.01) of ocular attacks and in the maintenance steroid dose (p < 0.01) when compared with conventional therapy. The frequent side effects were paraesthesia-hyperesthesia, fatigue, nausea, hirsutism and dose-related nephrotoxicity in one patient. Conclusion: The results of the study suggest that low dose CSA combined with low dose corticosteroid may be an effective therapeutic alternative in the treatment of severe refractory Behcet's uveitis.