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Chlorambucil combination therapy in refractory serpiginous choroiditis: A cure?
Arash Maleki1,2, Anapatricia Maldonado Cerda1,2, Cristina M Garcia1,2
1Massachusetts Eye Research and Surgery Institution, Waltham, MA, United States.
American Journal of Ophthalmology Case Reports
|February 22, 2021
Summary
For refractory serpiginous choroiditis, combining intravitreal dexamethasone implants with chlorambucil offers a promising treatment. Maintaining stable white blood cell counts is crucial for successful chlorambucil therapy.
Area of Science:
- Ophthalmology
- Immunology
Background:
- Serpiginous choroiditis is a rare inflammatory eye condition.
- Cases refractory to oral prednisone and chlorambucil require novel therapeutic strategies.
Observation:
- Four female patients with advanced serpiginous choroiditis, unresponsive to conventional therapy, were studied.
- Two patients achieved remission with a combination of chlorambucil and intravitreal dexamethasone implant or infliximab.
- Two patients did not achieve remission and declined further invasive treatment.
Findings:
- Stable white blood cell counts within the 3000-4500 cells/μl range are critical for effective chlorambucil treatment.
- Intravitreal dexamethasone implant combined with chlorambucil demonstrated efficacy in inducing and maintaining remission.
Implications:
- This combined therapy presents a viable option for managing severe, treatment-resistant serpiginous choroiditis.
- Further research is warranted to explore long-term outcomes and safety profiles of this regimen.
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