Chlorambucil combination therapy in refractory serpiginous choroiditis: A cure?
Chlorambucil
Cyclophosphamide
Dexamethasone implant
Infliximab
Serpiginous choroiditis
Journal
American journal of ophthalmology case reports
ISSN: 2451-9936
Titre abrégé: Am J Ophthalmol Case Rep
Pays: United States
ID NLM: 101679941
Informations de publication
Date de publication:
Mar 2021
Mar 2021
Historique:
received:
27
08
2020
revised:
07
12
2020
accepted:
11
01
2021
entrez:
22
2
2021
pubmed:
23
2
2021
medline:
23
2
2021
Statut:
epublish
Résumé
To find a remedy for serpiginous choroiditis refractory to oral prednisone and chlorambucil treatment. Eight eyes of four patients (all female) with advanced macular involvement secondary to serpiginous choroiditis were included in the study. The average age of the patients was 45.2 years. One eye of each patient was legally blind and the lesion was close to the fovea in the other eye. All four patients failed oral prednisone and chlorambucil therapy. However, case 1 responded to chlorambucil treatment after intravitreal dexamethasone implant implantation and discontinuation of oral prednisone. Case 2 responded to chlorambucil therapy when oral prednisone was stopped in combination with infliximab therapy. Due to long follow-up period of more than four years, these two cases are considered to be cured. Case 3 and case 4 were not able to achieve remission with chlorambucil and immunomodulatory therapy. They refused intravitreal steroid implant due to side effects profile. The stability of WBC counts within toxic levels close to normal or lower limits of normal (3000-4500 cells/μl) during treatment with chlorambucil is an essential factor for the success of this therapy. A combination of dexamethasone intravitreal implant with chlorambucil therapy can be an effective and promising regimen in inducing and maintaining remission in refractory serpiginous choroiditis patients who fail a combination of systemic corticosteroid and chlorambucil therapy.
Identifiants
pubmed: 33615036
doi: 10.1016/j.ajoc.2021.101014
pii: S2451-9936(21)00005-0
pmc: PMC7881218
doi:
Types de publication
Case Reports
Langues
eng
Pagination
101014Informations de copyright
© 2021 The Authors.
Déclaration de conflit d'intérêts
No conflicting relationship exists for any author.
Références
Ophthalmology. 1991 Jun;98(6):944-51; discussion 951-2
pubmed: 1866149
Indian J Ophthalmol. 2019 Mar;67(3):325-333
pubmed: 30777946
Ocul Immunol Inflamm. 2018;26(3):469-476
pubmed: 27849419
Orphanet J Rare Dis. 2016 May 12;11(1):61
pubmed: 27175923
Ophthalmologica. 1975;171(4-5):347-52
pubmed: 1165913
Ophthalmology. 2002 Aug;109(8):1506-13
pubmed: 12153803
Klin Monbl Augenheilkd. 2002 Apr;219(4):243-9
pubmed: 12022010
Retina. 1988;8(2):125-31
pubmed: 2458620
Contact Dermatitis. 2018 Feb;78(2):171-173
pubmed: 29341183
Am J Ophthalmol. 1974 Sep;78(3):415-28
pubmed: 4472398
Ann Intern Med. 1983 Jan;98(1):76-85
pubmed: 6336643
Br J Ophthalmol. 2002 Dec;86(12):1439-41
pubmed: 12446382
J Clin Pathol. 1993 Dec;46(12):1089-92
pubmed: 7904272
Br J Ophthalmol. 1990 Jun;74(6):353-7
pubmed: 2378842
Acta Ophthalmol (Copenh). 1981 Oct;59(5):707-18
pubmed: 6171987
J Rheumatol. 1999 Apr;26(4):898-903
pubmed: 10229413
J Pediatr. 1973 Apr;82(4):598-606
pubmed: 4121460
Br J Ophthalmol. 2017 Mar;101(3):327-332
pubmed: 27256717
Ophthalmology. 2002 Feb;109(2):370-7
pubmed: 11825825
J Pediatr. 1978 Feb;92(2):295-8
pubmed: 621612
Toxicol Lett. 2016 Feb 26;244:56-71
pubmed: 26383629
Indian J Ophthalmol. 2015 Apr;63(4):318-22
pubmed: 26044470
Trans Am Ophthalmol Soc. 1984;82:264-81
pubmed: 6535326
Retina. 1989;9(4):292-301
pubmed: 2483464
Lancet. 1984 Feb 4;1(8371):246-9
pubmed: 6142995
Am J Ophthalmol. 1979 Feb;87(2):133-42
pubmed: 434065
J Ophthalmic Inflamm Infect. 2016 Dec;6(1):31
pubmed: 27576870
Br J Ophthalmol. 1976 Jan;60(1):55-7
pubmed: 773421
Ocul Immunol Inflamm. 2001 Sep;9(3):153-67
pubmed: 11815884
Surv Ophthalmol. 2013 May-Jun;58(3):203-32
pubmed: 23541041
Ocul Immunol Inflamm. 2001 Dec;9(4):219-29
pubmed: 11935432
Retina. 2016 Sep;36(9):1758-66
pubmed: 26807626
Ocul Immunol Inflamm. 2005 Feb;13(1):59-66
pubmed: 15804771
Ocul Immunol Inflamm. 2018;26(2):228-238
pubmed: 27754769
Haematologica. 1991 Jul-Aug;76(4):342-5
pubmed: 1794742
Br J Ophthalmol. 1974 Sep;58(9):777-83
pubmed: 4433491
Am J Ophthalmol. 1979 Oct;88(4):683-9
pubmed: 92200
J Pediatr. 1980 Oct;97(4):653-6
pubmed: 7420231
Eye (Lond). 2012 Jun;26(6):862-5
pubmed: 22402699