Treatment of severe Graves' ophthalmopathy with cyclosporin A

Ten patients with severe Graves' ophthalmopathy, resistant to other therapeutic regimens were treated with cyclosporin A (CyA) over a period of 6 months. Clinically, 9 patients improved, 2 of them only after addition of corticosteroids. Intra-ocular tension on upward gaze decreased in all of these 9 patients (P less than 0.01). In 6 patients there was a significant decrease in eye muscle thickness under the treatment (P less than 0.05) as determined by computerized tomography. Side effects (e.g., paraesthesia, proteinuria) which were observed under higher doses of CyA, disappeared after lowering the dose. In only one out of 3 patients with hypertension an antihypertensive medication became necessary. CyA appears to be a valuable drug for treatment of severe Graves' ophthalmopathy when previous therapeutic regimens turned out to be unsuccessful.