Birdshot Retinopathy Medication

  • Author: C Michael Samson; Chief Editor: Hampton Roy Sr, MD   more...
 
Updated: Nov 28, 2011
 

Medication Summary

The goals of pharmacotherapy are to reduce morbidity and to prevent complications.

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Immunosuppressive agents

Class Summary

May have a beneficial effect on birdshot retinochoroidopathy inflammation.

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Cyclosporine (Sandimmune, Neoral)

 

Cyclic polypeptide that suppresses some humoral immunity and, to a greater extent, cell-mediated immune reactions, such as delayed hypersensitivity, allograft rejection, experimental allergic encephalomyelitis, and graft-versus-host disease for a variety of organs. For children and adults, base dosing on ideal body weight. The dose of 10 mg/kg/d is associated with a high incidence of nephrotoxicity and hypertension.

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Corticosteroids

Class Summary

Have both anti-inflammatory (glucocorticoid) and salt-retaining (mineralocorticoid) properties. Glucocorticoids have profound and varied metabolic effects. In addition, these agents modify the body's immune response to diverse stimuli.

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Prednisone (Deltasone, Sterapred, Orasone, Meticorten)

 

Immunosuppressant for treatment of autoimmune disorders; may decrease inflammation by reversing increased capillary permeability and suppressing PMN activity. Stabilizes lysosomal membranes and suppresses lymphocytes and antibody production.

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Antifungal agents

Class Summary

Their mechanism of action may involve an alteration of RNA and DNA metabolism or an intracellular accumulation of peroxide that is toxic to the fungal cell. They also may inhibit P450 enzymes involved in drug metabolism.

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Ketoconazole (Nizoral)

 

For use concomitantly with cyclosporine. Imidazole broad-spectrum antifungal agent that acts on several of the P450 enzymes, including the first step in cortisol synthesis, cholesterol side-chain cleavage, and conversion of 11-deoxycortisol to cortisol. Also increases levels of drugs metabolized by P450 enzymes, such as cyclosporine.

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Contributor Information and Disclosures
Author

C Michael Samson  MD, Associate Professor, Department of Ophthalmology, New York Medical College; Consulting Staff, Co-director of Uveitis Service, Director, Uveitis Fellowship, Department of Ophthalmology, New York Eye and Ear Infirmary; Director, Adesso Biosciences, Ltd.; President and CEO, CLS Pharmaceuticals; Private Practice, Vitreous Retina Macula Consultants of New York

C Michael Samson is a member of the following medical societies: American Academy of Ophthalmology, American Medical Association, American Uveitis Society, and Association for Research in Vision and Ophthalmology

Disclosure: Nothing to disclose.

Coauthor(s)

Amro Mohamed Mohamoud Ali, MB, ChB  Consulting Staff, New York Eye and Ear Infirmary

Amro Mohamed Mohamoud Ali, MB, ChB is a member of the following medical societies: American Academy of Ophthalmology

Disclosure: Nothing to disclose.

C Stephen Foster, MD, FACS, FACR, FAAO  Clinical Professor of Ophthalmology, Harvard Medical School; Consulting Staff, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary; Founder and President, Ocular Immunology and Uveitis Foundation, Massachusetts Eye Research and Surgery Institution

C Stephen Foster, MD, FACS, FACR, FAAO is a member of the following medical societies: Alpha Omega Alpha, American Academy of Ophthalmology, American Association of Immunologists, American College of Rheumatology, American College of Surgeons, American Federation for Clinical Research, American Medical Association, American Society for Microbiology, American Uveitis Society, Association for Research in Vision and Ophthalmology, Massachusetts Medical Society, Royal Society of Medicine, and Sigma Xi

Disclosure: Nothing to disclose.

Specialty Editor Board

Russell P Jayne, MD  Consulting Vitreoretinal Surgeon, The Retina Center at Las Vegas

Russell P Jayne, MD is a member of the following medical societies: American Medical Association, American Society of Cataract and Refractive Surgery, and American Society of Retina Specialists

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Steve Charles, MD  Director of Charles Retina Institute; Clinical Professor, Department of Ophthalmology, University of Tennessee College of Medicine; Adjunct Professor of Ophthalmology, Columbia College of Physicians and Surgeons; Clinical Professor Ophthalmology, Chinese University of Hong Kong

Steve Charles, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Retina Specialists, Club Jules Gonin, Macula Society, and Retina Society

Disclosure: Alcon Laboratories Consulting fee Consulting; OptiMedica Ownership interest Other; Topcon Medical Lasers Consulting fee Consulting

Lance L Brown, OD, MD  Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri

Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD  Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences

Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

References

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