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  3. Intravenous methylprednisolone induces rapid improvement in non-infectious uveitis: a multicentre study of 112 patients

Intravenous methylprednisolone induces rapid improvement in non-infectious uveitis: a multicentre study of 112 patients

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Autores de IDIVAL

Autores ajenos al IDIVAL

  • Beltrán E
  • Fonollosa A
  • Maíz O
  • Blanco A
  • Cordero-Coma M
  • Ortego N
  • Torre I
  • Francisco Hernández F
  • Muñoz-Fernández S
  • Esteban Ortega MDM
  • Diaz-Llopis M
  • Castañeda S

Unidades

Abstract

Objective Rapid control of intraocular inflammation in non-infectious uveitis (NIU) is mandatory to avoid irreversible structural and functional damage. In this study, we assessed the efficacy and safety of intravenous methylprednisolone (IVMP) pulses in the treatment of NIU. Methods A retrospective case series of 112 patients who received IVMP for the treatment of NIU, either isolated or associated with different underlying diseases, was studied. Intraocular inflammation (anterior chamber cells and vitritis) was the primary outcome measure. Secondary outcome measures were macular thickness and best corrected visual acuity (BCVA). Patients were assessed at baseline visit, and at days 2-5, 7, 15 and 30 after initiation of IVMP pulse therapy. Results A total of 112 patients (mean age 42 +/- 14.5 yrs) were assessed. An underlying immune-mediated disease was diagnosed in 73 patients. Inflammatory ocular patterns were panuveitis (n=68), posterior uveitis (n=30), anterior uveitis (AU) (n=12), and intermediate uveitis (n=2). Additionally, patients presented cystoid macular oedema (CME) (n=50), retinal vasculitis (n=37), and exudative retinal detachment (n=31). Therapies used before IVMP included intraocular glucocorticoids (n=4), high-dose oral systemic glucocorticoids (n=77), and conventional (n=107) or biologic (n=40) immunosuppressive drugs. IVMP dose ranged from 80 to 1,000 mg/day for 3-5 consecutive days. Improvement was observed in AU, vitritis, BCVA, CME, and retinal vasculitis. At first month evaluation, total remission was achieved in 19 patients. Side effects of IVMP were respiratory infections (n=3), uncontrolled hyperglycaemia (n=1), herpes zoster (n=1), and oral candidiasis (n=1). Conclusion IVMP pulse therapy was effective and safe, and achieved rapid control of NIU.

Datos de la publicación

ISSN/ISSNe:
0392-856X, 1593-098X

CLINICAL AND EXPERIMENTAL RHEUMATOLOGY  CLINICAL & EXPER RHEUMATOLOGY

Tipo:
Article
Páginas:
142-149
PubMed:
33666160

Citas Recibidas en Web of Science: 8

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Keywords

  • non-infectious uveitis; intravenous methylprednisolone; best corrected visual acuity; anterior chamber cells; vitritis

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