Immunosuppressive Therapy of Ocular Inflammatory Diseases

Abstract

Clinical improvement with the immunosuppressants methotrexate or cyclophosphamide was observed in 17 of 25 patients with refractory ocular inflammatory diseases. Because suppression of immune responses was desirable, five patients whose sympathetic ophthalmia was controlled with steroids had surgery performed on the remaining eye with the addition of immunosuppressive therapy. Good surgical results were obtained in each case. The anti-inflammatory effects of these agents are related to a specific inhibition of mononuclear cellular response. Although varying degrees of altered immune responses were obtained with these drugs, consistent correlation between clinical results and the extent of immunosuppression could not be established. The effectiveness of immunosuppressive therapy has been shown to be a potentially useful adjunct in the short-term therapy of ocular inflammation. One must weigh the potential benefits of antimetabolites against their inherent toxicities.