Ophthalmology · 2003
Infliximab in the treatment of refractory posterior uveitis.
Клинический случайКлиническое исследованиеСтатьяНазвание и аннотация: Перевод пока не подготовлен
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Joseph Annie, Raj Dev, Dua Harminder S, Powell Pauline T, Lanyon Peter C, Powell Richard J
Аннотация
PURPOSE: To determine the efficacy and safety of infliximab in the treatment of refractory posterior uveitis.
DESIGN: Noncomparative interventional case series.
PARTICIPANTS: Five patients with posterior uveitis were treated: 3 had Behçet's syndrome, and 2 had idiopathic posterior uveitis.
INTERVENTIONS: Patients with sight-threatening uveitis refractory to other immunosuppressive agents were treated with infliximab.
MAIN OUTCOME MEASURES: Intraocular inflammation, by using binocular indirect ophthalmoscopy score, retinal vasculitis, and visual acuity. Adverse effects of infliximab were documented.
RESULTS: Within 2 weeks of the first infusion of infliximab, 4 of 5 patients showed marked improvement in vitreous haze and visual acuity. By the 6-month follow-up, the same four patients had achieved remission of posterior uveitis and had successfully withdrawn all other immunosuppressive therapy. Further infusions of infliximab were required in 3 patients. One patient developed ocular and systemic tuberculosis, which responded to antituberculous treatment.
CONCLUSIONS: Infliximab is effective in the treatment of sight-threatening refractory posterior uveitis. However, patients should be thoroughly screened for tuberculosis before treatment and followed up closely during and after therapy with infliximab.
DESIGN: Noncomparative interventional case series.
PARTICIPANTS: Five patients with posterior uveitis were treated: 3 had Behçet's syndrome, and 2 had idiopathic posterior uveitis.
INTERVENTIONS: Patients with sight-threatening uveitis refractory to other immunosuppressive agents were treated with infliximab.
MAIN OUTCOME MEASURES: Intraocular inflammation, by using binocular indirect ophthalmoscopy score, retinal vasculitis, and visual acuity. Adverse effects of infliximab were documented.
RESULTS: Within 2 weeks of the first infusion of infliximab, 4 of 5 patients showed marked improvement in vitreous haze and visual acuity. By the 6-month follow-up, the same four patients had achieved remission of posterior uveitis and had successfully withdrawn all other immunosuppressive therapy. Further infusions of infliximab were required in 3 patients. One patient developed ocular and systemic tuberculosis, which responded to antituberculous treatment.
CONCLUSIONS: Infliximab is effective in the treatment of sight-threatening refractory posterior uveitis. However, patients should be thoroughly screened for tuberculosis before treatment and followed up closely during and after therapy with infliximab.