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May 1969

Immunosuppressive Therapy of Ocular Inflammatory Diseases: An Alternative?

Author Affiliations

Nashville, Tenn

Arch Ophthalmol. 1969;81(5):612-613. doi:10.1001/archopht.1969.00990010614002

IN AN EXCELLENT paper appearing elsewhere in this issue of the Archives, Vernon G. Wong, MD, reports his experience with the antimetabolites methotrexate and cyclophosphamide on an array of refractory ocular inflammatory diseases. A paramount ethical issue is whether the use of these toxic drugs is justified in the treatment of nonlife-threatening diseases. In essence, patients are being judiciously poisoned for potentially blinding eye inflammations of obscure cause with drugs whose mechanism of action and effect on the disease under scrutiny is unknown. Moreover, in many instances, the eye diseases chosen by the author for therapeutic trial have an unpredictable clinical course with frequent remissions and exacerbations. By the same token, however, longterm systemically administered corticosteroids are not exempt from significant morbidity and occasional mortality when given in the supraphysiologic doses necessary to control these same ocular inflammatory conditions. Therefore, as an alternative, sane and deliberate pilot investigations with immunosuppressive

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