Mycophenolic acid in the treatment of birdshot chorioretinopathy: long-term follow-up.
AIM
To assess the long-term efficacy and tolerability of both derivatives of mycophenolic acid, mycophenolate mofetil (MMF) and mycophenolate sodium (MPS), in the therapy of patients with birdshot chorioretinopathy (BSCR).


METHODS
Retrospective analysis of 24 patients (48 eyes) with BSCR, treated with MMF or MPS with a follow-up of at least 1 year. The main outcome measures included control of inflammation, steroid-sparing potential and side effects. Secondary outcome measure was the development of retinal function during the therapy measured by best-corrected visual acuity (BCVA), visual field and/or electroretinography (ERG).


RESULTS
Twelve patients (50%) were treated with MMF and 12 patients (50%) with MPS. Control of intraocular inflammation, defined as complete lack of clinical and angiographic signs of inflammatory activity, was achieved in 16 of 24 patients (67%). The angiographic signs of activity were significantly reduced during the follow-up (p<0.05). No significant difference was found in the mean BCVA, the visual field and the ERG parameters during the treatment compared with the baseline (p>0.05). In 20 out of 21 patients (95%) who received systemic corticosteroids, the corticosteroids could be tapered to a daily dose of ≤10 mg (rate 0.26/patient-year). Drug-related side effects occurred in 12 patients (50%, rate 0.16/patient-year). In four patients (17%), a therapy switch from MMF to MPS was undertaken due to gastrointestinal discomfort.


CONCLUSIONS
Derivatives of mycophenolic acid are effective and safe drugs for the treatment of BSCR. In cases with gastrointestinal side effects, a therapy switch from MMF to MPS should be considered.
['Doycheva|Deshka|D|', 'Jägle|Herbert|H|', 'Zierhut|Manfred|M|', 'Deuter|Christoph|C|', 'Blumenstock|Gunnar|G|', 'Schiefer|Ulrich|U|', 'Stingl|Katarina|K|', 'Januschowski|Kai|K|', 'Voykov|Bogomil|B|', 'Stuebiger|Nicole|N|']
D000328:Adult D000368:Aged D000080365:Birdshot Chorioretinopathy D002825:Chorioretinitis D004596:Electroretinography D005260:Female D005451:Fluorescein Angiography D005500:Follow-Up Studies D005938:Glucocorticoids D006801:Humans D007166:Immunosuppressive Agents D008297:Male D008875:Middle Aged D009173:Mycophenolic Acid D012160:Retina D012189:Retrospective Studies D041623:Tomography, Optical Coherence D014792:Visual Acuity D014794:Visual Fields
Inflammation