Walton R C, Nussenblatt R B, Whitcup S M
Clinical Branch, National Eye Institute, National Institutes of Health, Bethesda, Maryland, USA.
Ophthalmology. 1998 Nov;105(11):2028-34. doi: 10.1016/S0161-6420(98)91120-4.
To review the safety and efficacy of cyclosporine in the treatment of children with severe bilateral sight-threatening intermediate uveitis or panuveitis.
DESIGN/PARTICIPANTS: A retrospective chart review was performed on all children younger than 18 years of age with chronic bilateral sight-threatening uveitis who were treated with cyclosporine.
Assessment of the therapeutic efficacy and development of adverse effects of cyclosporine after 6 months, 2 years, and 4 years of therapy was performed.
Between 1983 and 1992, 15 children and adolescents were treated with cyclosporine. After 6 months, visual acuity improved or stabilized in 82.1% of eyes, while median vitreous inflammation decreased from 2.0 to 0.5. After 2 and 4 years, visual acuity improved or stabilized in 64% and 75% of eyes, respectively. Median vitreous inflammation remained 0.5 after 2 and 4 years of therapy. Mean creatinine clearance and hemoglobin values decreased and serum creatinine increased after 6 months. After 2 years, only mean hemoglobin values remained decreased. After 4 years, no significant differences were noted in any of the laboratory studies. The most frequently noted side effects included transient increases in serum creatinine in 53%, gingival hyperplasia in 40%, and hirsutism in 20% of patients.
The authors' results suggest that cyclosporine is a safe and effective therapy for the treatment of children with severe bilateral sight-threatening intermediate uveitis or panuveitis.
回顾环孢素治疗重度双侧威胁视力的中间葡萄膜炎或全葡萄膜炎患儿的安全性和有效性。
设计/研究对象：对所有接受环孢素治疗的18岁以下慢性双侧威胁视力的葡萄膜炎患儿进行回顾性病历审查。
在治疗6个月、2年和4年后评估环孢素的治疗效果及不良反应的发生情况。
1983年至1992年期间，15名儿童和青少年接受了环孢素治疗。6个月后，82.1%的患眼视力改善或稳定，同时玻璃体炎症中位数从2.0降至0.5。2年和4年后，分别有64%和75%的患眼视力改善或稳定。治疗2年和4年后，玻璃体炎症中位数仍为0.5。6个月后，平均肌酐清除率和血红蛋白值下降，血清肌酐升高。2年后，仅平均血红蛋白值仍较低。4年后，各项实验室检查均未发现显著差异。最常见的副作用包括53%的患者血清肌酐短暂升高、40%的患者牙龈增生和20%的患者多毛症。
作者的研究结果表明，环孢素是治疗重度双侧威胁视力的中间葡萄膜炎或全葡萄膜炎患儿的一种安全有效的疗法。
