%0 Journal Article
%T Role of antimetabolites in recalcitrant idiopathic orbital inflammatory syndrome
%A Priya Yamini
%A Nithyanandam Suneetha
%A Reddy Manjoo
%J Oman Journal of Ophthalmology
%D 2011
%I Medknow Publications
%X Background : High-dose systemic steroids are the primary modality of treatment for idiopathic orbital inflammatory syndrome (IOIS). Occasionally patients experience a relapse of symptoms on tapering steroids or require large doses of steroid, predisposing them to the adverse effects of steroids. Aim : We present our experience with the management of three patients with recalcitrant IOIS, with immunosuppressive therapy, using antimetabolites. Materials and Methods : A retrospective review of the medical records of the patients being reported. Results: Two patients were treated with Methotrexate and one with Azathioprine for a duration of 6-24 months. Two patients were symptom-free three years after stopping the medication. One was doing well clinically with methotrexate therapy alone, when he was lost to follow-up after six months. No adverse effects of immunosuppressive therapy were encountered. Conclusion : High-dose systemic steroid therapy is the first-line treatment for IOIS, but in refractory or steroid-dependent cases, immunosuppressive therapy with antimetabolites is a safe and effective treatment alternative to steroids. However, treatment with antimetabolites warrants close monitoring for complications like bone marrow suppression and liver dysfunction, especially because long-term treatment is required.
%K Azathioprine
%K Idiopathic orbital inflammatory syndrome
%K immunosuppressive therapy
%K methotrexate
%K steroid-dependent
%U http://www.ojoonline.org/article.asp?issn=0974-620X;year=2011;volume=4;issue=1;spage=21;epage=24;aulast=