Low dose cyclosporin A therapy in chronic posterior uveitis

Nine patients with chronic posterior endogenous uveitis of varying aetiology, not satisfactorily controlled with systemic corticosteroids alone, were treated with low dose oral Cyclosporin A (mean maintenance dose 4.0 +/- 1.1 mg/kg/day). Six of the nine patients also continued to receive oral prednisolone (15 mg/day or less). During a follow up period of 6-30 (mean 17) months, seven have shown sustained visual improvement. Nephrotoxicity was the major side effect with serum creatinine concentration (mean +/- 1SD) rising from 91 +/- 7 mumol/l to 115 +/- 13 mumol/l (0.01 less than p less than 0.05) after the first twelve months of treatment. Other observed side effects have included taste disturbance, hypomagnesaemia, and hypertension. Cyclosporin A treatment is of value in the management of severe intraocular inflammation, unresponsive to conventional therapy, but the optimum duration of therapy remains to be established and nephrotoxicity is the major dose limiting effect.