Treatment of severe Graves' ophthalmopathy with cyclosporin A

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Abstract
Ten patients with severe Graves'' ophthalmopathy, resistant to other therapeutic regimens were treated with cyclosporin A (CyA) over a period of 6 months. Clinically, 9 patients improved, 2 of them only after addition of corticosteroids. Intra-ocular tension on upward gaze decreased in all of these 9 patients (P < 0.01). In 6 patients there was a significant decrease in eye muscle thickness under the treatment (P < 0.05) as determined by computerized tomography. Side effects (e.g., paraesthesia, proteinuria) which were observed under higher doses of CyA, disappeared after lowering the dose. In only one out of 3 patient with hypertension an antihypertensive medication became necessary. CyA appears to be a valuable drug for treatment of severe Graves'' ophthalmopathy when previous therapeutic regimens turned out to be unsuccessful.