Treatment of severe refractory uveitis with intravenous cyclophosphamide.

OBJECTIVE: We assessed the efficacy of intravenous (iv) cyclophosphamide therapy for patients with uveitis.
METHODS: 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.
RESULTS: 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.
CONCLUSION: 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.