Low‐dose‐corticosteroids as long‐term monotherapy ‐ sufficient immunosupression in patients with chronic uveitis

Abstract

Abstract Purpose The aim of this study has been to identify a subgroup of patients with chronic uveitis that could be treated with low dose systemic corticosteroids alone in regard to prevent relapse of inflammation and associated complications of uveitis (including loss of vision) without important side effects. Methods In a retrospective study we included consecutive patients > 18 years of age attending the Interdisciplinary Uveitis Center Heidelberg that met the following criteria: non‐infectious uveitis without regard to anatomical presentation, previous successful treatment with tapered prednisone dose and relapse after complete cessation. The systemic prednisone dose was tapered until dosage was below or equal 7,5 mg prednisone per day without relapse of disease for at least 60 days. The criteria that the efficacy of low dose prednisone treatment had been judged on were visual acuity and anterior chamber cells. Results So far 20 patients (14 female and 6‐male) were included. Systemic diseases were found in 12 patients: 6 patients were diagnosed with sarcoidosis (2 histologically confirmed), 2 patients with psoriasis, one with colitis ulcerosa, one had autoimmune hepatitis, one with Lyme disease and one with multiple sclerosis. After a median observation period of 210 days (range 88‐810 days), 14 patients remained stable in regard to visual acuity and inflammation cells on a median final prednisone dose of 3,5 mg (range 1‐7,5 mg). Conclusion In this retrospective study we could show that a low dose systemic prednisone treatment is effective in patients with chronic uveitis.