The patient was treated with pulse intravenous methylprednisolone sodium succinate (Solu-Medrol), 650 mg/d (30 mg/kg), for 3 days followed by oral prednisone, 50 mg/d, cyclosporine, 60 mg twice daily (5.2 mg/kg), and methotrexate, 12.5 mg every week. The patient's family elected expeditious enucleation of the right eye, with histopathologic examination of the enucleated eye showing prominent choroidal granulomatous inflammation consistent with SO (Figure 2). The aforementioned regimen led to initial improvement, with all chorioretinal lesions gaining an atrophic appearance (Figure 1C and Figure 3). However, on steroid tapering to 40 mg of prednisone daily over 4 weeks, a recurrence of panuveitis required a repeated course of pulse methylprednisolone followed by oral prednisone, 50 mg/d, cyclosporine, 80 mg twice daily (6.5 mg/kg), and methotrexate, 12.5 mg every week. A second attempt to taper corticosteroids led to a third flare 4 months later, which occurred a week after treatment with oral prednisone was discontinued. This required a third round of pulse intravenous methylprednisolone followed by oral prednisone, 60 mg/d, cyclosporine, 100 mg twice daily, and substitution of mycophenolate mofetil, 600 mg twice daily, for methotrexate. His cyclosporine dose subsequently was reduced to 75 mg twice daily owing to elevation of the creatinine level. A third attempt to taper his prednisone dosage to 15 mg/d over the next 2 months led to another recurrence, requiring an oral steroid increase to 30 mg/d and initiation of treatment with intravenous daclizumab, 2 mg/kg every 2 weeks, with continuation of treatment with mycophenolate and cyclosporine; however, inflammation recurred 3 months later when the patient reached a prednisone dosage of 7.5 mg/d. At this time, treatment with daclizumab was stopped and treatment with infliximab was started at a dosage of 10 mg/kg every 4 weeks, with the prednisone dosage increased to 30 mg/d and the dosages of mycophenolate and cyclosporine maintained.