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Int Ophthalmol. 2015 Apr;35(2):281-5. doi: 10.1007/s10792-015-0051-0. Epub 2015 Feb 24.

Clinical outcomes of intravenous immunoglobulin therapy in refractory uveitis.

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1
Medical Retina and Uveitis Department, Bristol Eye Hospital, University Hospitals Bristol NHS Foundation Trust, Lower Maudlin Street, Bristol, BS1 2LX, UK.

Abstract

Intravenous immunoglobulin (IVIg) therapy has multiple mechanisms of immunomodulatory action. We wished therefore to assess its efficacy in a spectrum of patients with refractory uveitis. Retrospective review of clinical charts was conducted to document response to IVIg treatment in consecutive patients with treatment-refractory uveitis. Main outcome measures were control of intraocular inflammation, visual acuity, progression of the disease, and complications. Four (two male) patients, with a mean age at the beginning of the treatment of 47 years (range: 39-64), were included in the study. Indication for treatment was patients with active non-infectious uveitis refractory to steroids and immunomodulatory therapy. All patients received a course of 0.5 g/kg per day of IVIg for three consecutive days, repeating this course at a mean of 11 week (range: 2-39 weeks) intervals when indicated clinically. The median duration of the IVIg therapy was 7 months (range: 3-14 months). In three patients treatment resulted in stabilisation and prevention of progression of the disease, and additionally in two patients it facilitated a decrease in prednisolone dose. Treatment failed to induce long-term remission in one patient with recurrence of macular oedema. IVIg was well tolerated with neither immediate nor longer-term adverse events observed. In three out of four cases IVIg was an effective adjunctive therapy and well tolerated for the management of treatment-refractory uveitis.

PMID:
25708281
DOI:
10.1007/s10792-015-0051-0
[Indexed for MEDLINE]

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