Treatment of severe refractory uveitis with intravenous cyclophosphamide

We assessed the efficacy of intravenous (iv) cyclophosphamide therapy for patients with uveitis.

Eleven patients with uveitis were treated with iv cyclophosphamide. Patients were from a tertiary care, referral practice, had failed oral corticosteroid therapy, and had disease that interfered with activities of daily living.

Only 5 patients benefitted and the improvement was sustained without additional immunosuppression in only 2 patients, one of whom had only mild eye disease and was receiving cyclophosphamide for a central nervous system vasculitis. Four patients worsened during the therapy.

Although iv cyclophosphamide may have fewer risks than daily, oral cyclophosphamide, the majority of patients with uveitis do not experience a sustained benefit from this therapeutic approach.