Infliximab in the Treatment of Refractory Posterior Uveitis

Ophthalmology. 2003 Jul;110(7):1449-53. doi: 10.1016/S0161-6420(03)00406-8.

Abstract

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 By the 6-month follow-up, the same four patients had achieved remission of posterior uveitis and had successfully withdrawn all other immunosuppressive therapy.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.

Publication types

  • Case Reports
  • Clinical Trial

MeSH terms

  • Adult
  • Antibodies, Monoclonal / administration & dosage
  • Antibodies, Monoclonal / adverse effects
  • Antibodies, Monoclonal / therapeutic use*
  • Chronic Disease
  • Drug Resistance
  • Female
  • Humans
  • Immunosuppressive Agents
  • Infliximab
  • Infusions, Intravenous
  • Male
  • Middle Aged
  • Ophthalmoscopy
  • Prospective Studies
  • Safety
  • Treatment Outcome
  • Tumor Necrosis Factor-alpha / immunology
  • Uveitis, Posterior / drug therapy*

Substances

  • Antibodies, Monoclonal
  • Immunosuppressive Agents
  • Tumor Necrosis Factor-alpha
  • Infliximab