PMID: 2488429Jan 1, 1989Paper

Classical immunosuppressive agents

Bulletin de la Société belge d'ophtalmologie
A C Martenet

Abstract

Immunodepressive or immunoregulatory drugs might be indicated among the therapeutic possibilities in uveitis and associated diseases, especially in those cases, which resist to specific treatment and steroids, and in those in which disorders of the immune system play a pathogenetic role. Classical cytostatic drugs mainly act by a reduction of the amount of circulating lymphocytes. The most useful seem to be the alkylating drugs (chlorambucil, cyclophosphamide) and antimitotics (procarbazine, colchicine), or antifolic (methotrexate), while the antipurines (azathioprine) seem to us less effective. Such therapy requires the full consent of the patient. The dosage of the drug has to be well established in order to keep the total amount of leucocytes between 4,000-5,000/mm3. Side effects can be hair loss, sterility, rarely hemorrhagic cystitis, and, mostly only in the initial therapy period, nausea and vomiting. Teratogenic risks seem non-existent. Since the therapeutical effect comes rather slowly, a local steroid therapy can be added. Absolute indications for such therapy are Behçet and sympathetic ophthalmitis, while all severe chronic uveitis forms are relative indications. Acute iritis and chorioretinitis are contraindications....Continue Reading

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