Infliximab therapy for idiopathic retinal vasculitis, aneurysm, and neuroretinitis syndrome

J Ocul Pharmacol Ther. 2011 Aug;27(4):407-10. doi: 10.1089/jop.2010.0189. Epub 2011 May 12.


Purpose: We report our experience in treating 2 patients of idiopathic retinal vasculitis, aneurysm, and neuroretinitis (IRVAN) syndrome with antitumor necrosis factor agent, infliximab, who showed a very favorable response to treatment.

Methods: Two patients with clinical diagnosis of IRVAN syndrome were included in the study. The visual acuity was affected due to ocular inflammation and presence of macular edema due to exudation around the optic nerve.

Results: The patients did not respond to initial treatment with oral steroids, and visual acuity continued to deteriorate due to macular exudation. Infliximab therapy resulted in prompt resolution of the inflammatory reaction and retinal exudation, with improvement in visual acuity, that was subsequently maintained with maintenance therapy. The intravenous infliximab infusions were scheduled at 0, 4, 8, and 12 weeks initially, and every 2 months thereafter. Retinal neovasculariztion in each patient was managed by pan retinal photocoagulation.

Conclusion: Infliximab therapy may be useful in reducing inflammation and leakage from the optic nerve in patients with IRVAN syndrome. This may help preserve or improve visual acuity. However, further studies are required to evaluate the long-term benefits of this therapy.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aneurysm / complications
  • Aneurysm / drug therapy*
  • Aneurysm / physiopathology
  • Anti-Inflammatory Agents / therapeutic use
  • Antibodies, Monoclonal / therapeutic use*
  • Female
  • Humans
  • Infliximab
  • Infusions, Intravenous
  • Laser Coagulation / methods
  • Macular Edema / drug therapy
  • Macular Edema / etiology
  • Male
  • Optic Nerve / pathology
  • Retinal Vasculitis / complications
  • Retinal Vasculitis / drug therapy*
  • Retinal Vasculitis / physiopathology
  • Retinitis / complications
  • Retinitis / drug therapy*
  • Retinitis / physiopathology
  • Syndrome
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors
  • Visual Acuity / drug effects


  • Anti-Inflammatory Agents
  • Antibodies, Monoclonal
  • Tumor Necrosis Factor-alpha
  • Infliximab