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Association of systemic steroids and mycophenolate mofetil as rescue therapy for uveitic choroidal neovascularization unresponsive to the traditional immunesuppressants: interventional case series

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Abstract

To study the efficacy of systemic steroids (SS) associated with mycophenolate mofetil (MMF) for the control of juxta/sub-foveal uveitic choroidal neovascularization (CNV) unresponsive to the traditional immunosuppressive agents. Patients with juxta/sub-foveal uveitic CNV unresponsive to the traditional immunesuppressive drugs were treated with SS and MMF. The study was designed as a prospective, consecutive, open-label, interventional case series. Visual gain and loss were defined as improving or worsening of two or more lines of best-corrected visual acuity (BCVA), respectively. CNV size outcome was dichotomized as “increased” or “stable/reduced”, if increased >200 μm2, or reduced ≥200 μm2 or not modified by 200 μm2, respectively. Nine cases (12 eyes) have been considered; ages ranged from 27 to 56 years. The mean follow-up time was 18.2 ± 2.9 months (min: 14 months, max: 23 months). At base-line, the mean BCVA was 0.3 ± 0.17, improving up to 0.57 ± 0.25 and to 0.63 ± 0.22 (P < 0.001, paired t-test) at the 6 and 12-month follow-ups, respectively. At the last follow-up, all the patients had stable/improved BCVA (P < 0.0001, Fisher’s exact test) and stable/reduced lesion size (P < 0.0001, Fisher’s exact test). None of the patients complained of any severe adverse event during the treatment. The combination of SS and MMF seems to be a promising strategy in order to control uveitic CNVs unresponsive to the traditional immunosuppressive agents. Further studies are needed to validate the data of this case series.

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Acknowledgments

We thank Miss Barbara Tanucci for her significant help with the statistical analysis.

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Authors and Affiliations

  1. The Eye Clinic, Azienda Ospedaliero Universitaria-Ospedali Riuniti di Ancona, Via Conca 71, 60100, Torrette-Ancona, Italy

    Piergiorgio Neri, Mara Manoni, Cinzia Fortuna, Marta Lettieri, Cesare Mariotti & Alfonso Giovannini

  2. The Neuroscience Department-Ophthalmology Section, Polytechnic University of Marche, Ancona, Italy

    Mara Manoni, Cinzia Fortuna, Marta Lettieri, Cesare Mariotti & Alfonso Giovannini

Authors
  1. Piergiorgio Neri
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  2. Mara Manoni
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  3. Cinzia Fortuna
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  4. Marta Lettieri
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  5. Cesare Mariotti
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  6. Alfonso Giovannini
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Correspondence to Piergiorgio Neri.

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Neri, P., Manoni, M., Fortuna, C. et al. Association of systemic steroids and mycophenolate mofetil as rescue therapy for uveitic choroidal neovascularization unresponsive to the traditional immunesuppressants: interventional case series. Int Ophthalmol 30, 583–590 (2010). https://doi.org/10.1007/s10792-009-9323-x

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  • DOI: https://doi.org/10.1007/s10792-009-9323-x

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