Long-Term Follow-up of Tacrolimus Treatment in Immune Posterior Uveitis
| Autor: | L. Orte, Marta S. Figueroa, E. Ciancas |
|---|---|
| Rok vydání: | 2007 |
| Předmět: |
Adult
Male medicine.medical_specialty Long term follow up animal diseases Visual Acuity Biological Availability chemical and pharmacologic phenomena Tacrolimus 03 medical and health sciences 0302 clinical medicine Immune system Recurrence Humans Medicine Prospective Studies business.industry Uveitis Posterior General Medicine Middle Aged biochemical phenomena metabolism and nutrition Surgery Ophthalmology Treatment Outcome surgical procedures operative Posterior uveitis Creatinine 030221 ophthalmology & optometry bacteria Female business Immunosuppressive Agents 030217 neurology & neurosurgery Follow-Up Studies |
| Zdroj: | European Journal of Ophthalmology. 17:69-74 |
| ISSN: | 1724-6016 1120-6721 |
| DOI: | 10.1177/112067210701700110 |
| Popis: | To study the efficacy of tacrolimus in immune posterior uveitis.Twenty-one eyes of 11 patients with immune posterior uveitis under tacrolimus treatment were prospectively followed for 1 to 5 years. Tacrolimus dosage was adjusted to maintain blood levels in the range of 7 to 10 ng/mL. Systemic and ophthalmic evaluations were performed at baseline and during follow-up.After a mean follow-up of 45 months, no treatment other than tacrolimus was necessary to control the inflammation in 6 cases (54.5%). The number of annual recurrences decreased from 3.2 to 1.29 during tacrolimus treatment (p=0.021). In four patients, tacrolimus was suspended after a treatment period of 27+/-3.5 months and a follow-up period of 12 months free of uveitis relapses. All four were free from relapses following tacrolimus withdrawal. Visual acuity remained unchanged in 16/21 (76%) eyes, deteriorated in 4/21 (19%), and improved in 1/21 (5%). Renal function transiently deteriorated in four patients from basal serum creatinine levels of 0.84, 1.1, 0.88, and 0.78 mg/dL to maximum levels of 1.33, 2.48, 1.38, and 1.39 mg/dL, respectively. This deterioration was directly related with elevated tacrolimus serum levels, returning to normal when doses were reduced. During the overall controlled evolution period, a slight increase of serum creatinine from a basal value of 0.89+/-0.2 mg/dL to a final of 1+/-0.19 mg/dL was detected, which was not statistically significant. All secondary effects were mild, transient, and did not require interruption of long-term treatment to be controlled.Tacrolimus was well tolerated and useful in controlling posterior immune uveitis. Tacrolimus could be considered a real alternative to cyclosporine, and not only in cases of cyclosporine resistance or toxicity. |
| Databáze: | OpenAIRE |
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