High-dose Intravenous Corticosteroids for Ocular Inflammatory Diseases

Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.
Ocular immunology and inflammation (Impact Factor: 1.97). 04/2012; 20(2):91-9. DOI: 10.3109/09273948.2011.646382
Source: PubMed


To evaluate the effectiveness and risk of complications of high-dose intravenous pulsed corticosteroids for noninfectious ocular inflammatory diseases.
Retrospective cohort study in which 104 eyes of 70 patients who received high-dose intravenous corticosteroids for treatment of active ocular inflammation were identified from five centers. The main outcome measures were control of inflammation and occurrence of ocular or systemic complications within 1 month after treatment.
Within ≤1 month of starting treatment, 57% of eyes achieved complete control of inflammation (95% confidence interval (CI): 33-83%), improving to 82% when near-complete control was included (95% CI: 61-96%). Most eyes (85%; 95% CI: 70-95%) gained clinically significant improvement in anterior chamber inflammation. One patient developed a colon perforation during treatment. No other major complications were recorded.
Treatment of ocular inflammation with high-dose intravenous corticosteroids resulted in substantial clinical improvement for most cases within 1 month. Complications of therapy were infrequent.

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    • "In our study, the sclerosing subtype of IOIS had a poor therapeutic outcome, which is consistent with the other reports in the literature [12]. Administration of high-dose “pulsed” intravenous corticosteroids resulted in a substantial clinical improvement for most patients with ocular inflammation; this regimen may also be more effective than orally administered corticosteroids in patients with IOIS with retro-orbital involvement [13]. Because of incomplete collection of clinical data, our study did not address several important questions such as the incidence of deficits in color perception or the possible relationship between immunoglobulin G4 (IgG4)-positive plasma cells and the sclerosing subtype of IOIS. "
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