1. Mycophenolic acid in the treatment of birdshot chorioretinopathy: long-term follow-up
- Author
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Herbert Jägle, Deshka Doycheva, Katarina Stingl, Christoph Deuter, Kai Januschowski, Gunnar Blumenstock, Nicole Stuebiger, Ulrich Schiefer, Manfred Zierhut, and Bogomil Voykov
- Subjects
Adult ,Male ,medicine.medical_specialty ,Visual acuity ,Long term follow up ,610 Medizin ,Visual Acuity ,Mycophenolate ,Gastroenterology ,Mycophenolic acid ,Retina ,Cellular and Molecular Neuroscience ,Internal medicine ,medicine ,Electroretinography ,Humans ,Fluorescein Angiography ,Glucocorticoids ,Aged ,Retrospective Studies ,ddc:610 ,medicine.diagnostic_test ,business.industry ,Birdshot Chorioretinopathy ,Mycophenolate Sodium ,Middle Aged ,Mycophenolic Acid ,medicine.disease ,Birdshot chorioretinopathy ,Sensory Systems ,Surgery ,Ophthalmology ,Tolerability ,Chorioretinitis ,Female ,medicine.symptom ,Visual Fields ,business ,Immunosuppressive Agents ,Tomography, Optical Coherence ,medicine.drug ,Follow-Up Studies - Abstract
Aim: To assess the long-term efficacy and tolerability of both derivatives of mycophenolic acid, mycophenolate mofetil (MMF) and mycophenolate sodium (MPS), in the therapy of patients with birdshot chorioretinopathy (BSCR). Methods: Retrospective analysis of 24 patients (48 eyes) with BSCR, treated with MMF or MPS with a follow-up of at least 1 year. The main outcome measures included control of inflammation, steroid-sparing potential and side effects. Secondary outcome measure was the development of retinal function during the therapy measured by best-corrected visual acuity (BCVA), visual field and/or electroretinography (ERG). Results: Twelve patients (50%) were treated with MMF and 12 patients (50%) with MPS. Control of intraocular inflammation, defined as complete lack of clinical and angiographic signs of inflammatory activity, was achieved in 16 of 24 patients (67%). The angiographic signs of activity were significantly reduced during the follow-up (p0.05). In 20 out of 21 patients (95%) who received systemic corticosteroids, the corticosteroids could be tapered to a daily dose of ≤10 mg (rate 0.26/patient-year). Drug-related side effects occurred in 12 patients (50%, rate 0.16/patient-year). In four patients (17%), a therapy switch from MMF to MPS was undertaken due to gastrointestinal discomfort. Conclusions: Derivatives of mycophenolic acid are effective and safe drugs for the treatment of BSCR. In cases with gastrointestinal side effects, a therapy switch from MMF to MPS should be considered.
- Published
- 2014