Pulse cyclophosphamide therapy in the management of patients with macular serpiginous choroidopathy

PURPOSE: To evaluate safety and efficacy of intravenous pulse cyclophosphamide (CyP) in acute macular serpiginous choroiditis (SC). METHODS: Patients with acute macular SC with lesions threatening and/or involving fovea were enrolled. All patients received CyP (1 g/m(2) ) for 3 days followed by high-dose oral steroids (1.5 mg/kg) tapered over 6 months and monitored for visual acuity, response to treatment and systemic side effects. RESULTS: Eight patients (seven unilateral and one bilateral) with median age of 27 years (range: 13–40 years) were recruited. Mean visual acuity at presentation was 0.71 ± 0.35 logarithm of the minimum angle of resolution while postpulse visual acuity was 0.40 ± 0.32. Final mean visual acuity at 1-year was 0.31 ± 0.23 (P ≤ 0.05). Three eyes had recurrence and 3 patients developed transient hair loss with no other adverse effect. CONCLUSION: Intravenous CyP provides rapid resolution of lesion activity and thereby helps in maintaining good functional acuity.