Treatment of endogenous uveitis with cyclosporine A

Thirty patients suffering from severe sight-threatening bilateral chronic endogenous uveitis were treated with initial dosages of 10 mg/kg/d of CsA. After 1 month of therapy, all patients but one demonstrated a rapid decrease of the intraocular inflammatory processes along with an arrest of the deterioration of vision. After 1 year (or more) of treatment, most patients still show the same visual acuity achieved after 1 month. During the 3-year span of this study, attempts at tapering off the CsA dosage to less than 5 mg/kg/d induced a temporary flare-up in 20 of the 24 patients followed without interruption for more than 6 months. Nonetheless, control of the intraocular inflammation was finally achieved by 5 mg CsA/kg/d or less in 14 of the 25 patients. In six of these 14 patients the CsA dosage was further tapered to total discontinuation. Two of the six patients showed a rapid reactivation of the intraocular inflammatory processes with a profound decrease in vision within 1 and 3 weeks, respectively. In four patients, control of the intraocular inflammation and preservation of good visual acuity have been observed for a period of up to 18 months.