Pulse cyclophosphamide therapy in the management of patients with macular serpiginous choroidopathy

• Main Authors: Pradeep Venkatesh, Varun Gogia, Shikha Gupta, Akshay Tayade, Neha Shilpy, Bhavin M Shah, Randeep Guleria
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2015-01-01
• Series: Indian Journal of Ophthalmology
• Subjects: Advanced glaucoma; optical coherence tomography; reproducibility; retinal nerve fiber layer thickness; spectral domain; Ophthalmology; residents; surgical training; survey; Cytokine; diabetic macular edema; Macular GHPC; pulse cyclophosphamide; serpiginous choroidopathy
• Online Access: http://www.ijo.in/article.asp?issn=0301-4738;year=2015;volume=63;issue=4;spage=318;epage=322;aulast=Venkatesh

Purpose: To evaluate safety and efficacy of intravenous pulse cyclophosphamide (CyP) in acute macular serpiginous choroiditis (SC). Methods: Patients with acute macular SC with lesions threatening and/or involving fovea were enrolled. All patients received CyP (1 g/m 2 ) for 3 days followed by high-dose oral steroids (1.5 mg/kg) tapered over 6 months and monitored for visual acuity, response to treatment and systemic side effects. Results: Eight patients (seven unilateral and one bilateral) with median age of 27 years (range: 13-40 years) were recruited. Mean visual acuity at presentation was 0.71 ± 0.35 logarithm of the minimum angle of resolution while postpulse visual acuity was 0.40 ± 0.32. Final mean visual acuity at 1-year was 0.31 ± 0.23 (P ≤ 0.05). Three eyes had recurrence and 3 patients developed transient hair loss with no other adverse effect. Conclusion: Intravenous CyP provides rapid resolution of lesion activity and thereby helps in maintaining good functional acuity.