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Intravenous pulse methylprednisolone in the treatment of uveitis associated with multiple sclerosis
D Wakefield1, A Jennings, P J McCluskey
1School of Pathology University of New South Wales, Department of Ophthalmology, St Vincent's Hospital, Sydney, Australia. d.wakefield@unsw.edu.au
Purpose:
To demonstrate the safety and effectiveness of intravenous methylprednisolone (IVMP) in the treatment of uveitis in association with multiple sclerosis (MS).
Methods:
Uveitis is an unusual manifestation of MS that may be severe, chronic and require systemic immunosuppression therapy. High-dose IVMP has previously been shown to be effective in the treatment of inflammatory eye disease and MS. Eight episodes of uveitis in five patients with MS were treated over a 10-year period in an open, uncontrolled trial. Two patients had chronic anterior uveitis, one patient had bilateral panuveitis and two patients had intermediate uveitis.
Results:
All patients responded to IVMP with evidence of a decrease in intraocular inflammatory activity and improved visual acuity (VA) within 2 weeks of commencing treatment. There were no severe ocular or systemic steroid side effects.
Conclusions:
Intravenous methylprednisolone is an effective, well-tolerated form of therapy for uveitis in patients with MS.
Insights
Intravenous methylprednisolone (IVMP) effectively treats uveitis in multiple sclerosis (MS) patients, improving vision and reducing inflammation. This therapy was well-tolerated, with no severe side effects observed in the study.
Area of Science:
- Ophthalmology
- Neurology
- Immunology
Background:
- Uveitis is an uncommon but potentially severe complication of multiple sclerosis (MS).
- Chronic or severe uveitis in MS may necessitate systemic immunosuppressive treatments.
- High-dose intravenous methylprednisolone (IVMP) has demonstrated efficacy in managing inflammatory eye conditions and MS itself.
Purpose of the Study:
- To evaluate the safety and effectiveness of IVMP for treating uveitis associated with MS.
- To assess the impact of IVMP on intraocular inflammation and visual acuity in MS patients with uveitis.
Main Methods:
- An open, uncontrolled trial was conducted over a 10-year period.
- Eight episodes of uveitis in five MS patients were treated with high-dose IVMP.
- Patient cases included chronic anterior uveitis, bilateral panuveitis, and intermediate uveitis.
Main Results:
- All patients showed a positive response to IVMP treatment.
- A reduction in intraocular inflammatory activity was observed within two weeks.
- Improved visual acuity was noted in all treated patients.
- No severe ocular or systemic side effects related to steroid use were reported.
Conclusions:
- Intravenous methylprednisolone is a safe and effective treatment option for uveitis in patients diagnosed with multiple sclerosis.
- IVMP offers a well-tolerated therapeutic approach for this specific patient population.