Cyclosporine in Behçet's disease resistant to conventional therapy

Cyclosporine (cyclosporine A) at 7 to 16 mg/kg/day was administered for eight to 18 months to four patients with Behçet's disease with bilateral panuveitis resistant to the combination of prednisone, colchicine, and chlorambucil. Visual acuity was maintained or improved in all eyes. Color vision also improved significantly. A dramatic and significant decrease of the chronic vitreous haze occurred within the first two weeks of therapy and persisted until the end of the study. Retinal inflammation, including hemorrhages, exudates, edema, and fluorangiographic abnormalities, decreased progressively in all eyes. The severity of the anterior and posterior acute attacks also decreased significantly. This study suggests that cyclosporine is beneficial for the treatment of refractory and severe Behçet's disease, but its side effects require careful follow-up.