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Anales de la Sociedad Mexicana de Oftalmología y Archivos de la Asociación Para Evitar la Ceguera en México

2009, Número 6

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Rev Mex Oftalmol 2009; 83 (6)


Manejo y control de enfermedades inflamatorias oculares con inmunosupresores

Treviño-Rodríguez SL, González-Guajardo D, Pedroza-Seres M

Idioma: Español
Referencias bibliográficas: 26
Paginas: 369-376
Archivo PDF: 93.67 Kb.


RESUMEN

Objetivo: Evaluar el tratamiento inmunosupresor en pacientes con enfermedades inflamatorias oculares en base al control de la inflamación, capacidad visual y efectos colaterales.
Método: Estudio retrospectivo en 192 pacientes con enfermedad inflamatoria ocular, con o sin tratamiento previo, en el periodo 2008-2009, mediante la revisión de la base de datos electrónica.
Resultados: La azatioprina (43%) fue el inmunosupresor más utilizado en pars planitis y Vogt-Koyanagi-Harada, seguido por metotrexate (30%); ciclofosfamida (19%) en granulomatosis de Wegener y vasculitis retiniana y la dapsona (1.5%) en penfigoide de membranas mucosas oculares. Se presentaron alteraciones en los exámenes de laboratorio en 18%. Con la azatioprina y la ciclofosfamida aproximadamente 60% mejoró su capacidad visual, y con el metotrexate 50% permaneció con la misma, 90% recibieron antiinflamatorio esteroideo y/o no esteroideo.
Conclusiones: Los inmunosupresores son una alternativa benéfica para el manejo de las enfermedades inflamatorias oculares, ya que la mayoría logran mantener un control adecuado con un solo medicamento que se refleja en la estabilización o mejoría de la capacidad visual. Los efectos adversos significativos para la modificación o suspensión del inmunosupresor ocurren en 18% de los casos, por lo que se justifica su uso. Sin embargo, esto no exenta de seguir utilizando anti-inflamatorios esteroideos y/o no esteroideos.


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