Abstract
To evaluate the efficacy and tolerance of mycophenolate mofetil (MMF) for the treatment of noninfectious uveitis using the methods advocated by the Standardization of Uveitis Nomenclature (SUN) Working Group and to compare this with other studies of immunosuppression in ocular inflammation. Retrospective case series. Patients with noninfectious uveitis, followed at a tertiary Uveitis Service in São Paulo, Brazil, from 2007 to 2014 and receiving oral MMF for a minimum of 6 months, were retrospectively reviewed. After reaching an optimal dose of MMF, patients were evaluated after 6 (T6), 12 (T12), and 24 months (T24). The optimal dose varied for each patient (medium 2.2 g/day, range 1.0-3.0 g/day). The main outcome measures were: 1) success on achieving complete control of inflammation in both eyes and/or oral prednisone dosage reduction to ≤10 mg per day, and 2) the length of time required to reduce oral prednisone to ≤10 mg/day, partial control of ocular inflammation, and side effects. In a cohort of 16 patients with refractory noninfectious uveitis, 67% reached the ideal prednisone dose after 1 year of MMF treatment and 83% after 2 years of MMF treatment. Complete or partial inflammation control was achieved in 43.7% at T12. Two patients (14%) had disease remission after 4.7 years of MMF treatment. Adverse effects were gastrointestinal disturbances, infection, insomnia, and liver function abnormalities at a rate of 0.03 patient-year each. This small retrospective case series is consistent with the literature concerning the high efficacy and moderate tolerability of MMF in noninfectious uveitis. Observation of patients should be continued for at least 1 year to clearly determine MMF efficacy.
Highlights
Intraocular inflammatory diseases are a significant cause of visual impairment and were responsible for 10% of new cases of blindness in the United States in 1990(1)
In this retrospective case series, micofenolato de mofetila (MMF) was effective in treating refractory noninfectious uveitis
In the five published prospective studies, which included a total of 85 patients, 47% had better control of inflammation, and 100% were able to reduce the prednisone dose to ≤10 mg per day
Summary
Intraocular inflammatory diseases are a significant cause of visual impairment and were responsible for 10% of new cases of blindness in the United States in 1990(1). In a large retrospective case series from 1996 of 582 patients with uveitis, 18% went blind in one eye[2]. The refore, adequate treatment of inflammatory eye diseases is important for preserving vision. Uveitis can be classified as infectious or noninfectious. In a survey at Uveitis Service, Hospital das Clinicas, University of São Paulo School of Medicine (HC-FMUSP) in 2004, 37% of all cases of uveitis were noninfectious[3]. The current preferred treatment for noninfectious uveitis is based on systemic corticosteroids with or without immunosuppressants or immunomodulators[4,5]. Biological agents have been introduced for the treatment of selected cases of noninfectious uveitis[5,6]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
