Infliximab in the treatment of refractory posterior uveitis.
OBJECTIVE
To determine the efficacy and safety of infliximab in the treatment of refractory posterior uveitis.


METHODS
Noncomparative interventional case series.


METHODS
Five patients with posterior uveitis were treated: 3 had Behçet's syndrome, and 2 had idiopathic posterior uveitis.


METHODS
Patients with sight-threatening uveitis refractory to other immunosuppressive agents were treated with infliximab.


METHODS
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 By the 6-month follow-up, the same four patients had achieved remission of posterior uveitis and had successfully withdrawn all other immunosuppressive therapy.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.
Joseph
Annie
A
Department of Ophthalmology and Visual Sciences, B Floor, Eye and ENT Block, Queen's Medical Centre, Nottingham NG7 2UH, United Kingdom.
Raj
Dev
D
Dua
Harminder S
HS
Powell
Pauline T
PT
Lanyon
Peter C
PC
Powell
Richard J
RJ
D000328:Adult; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002908:Chronic Disease; D004351:Drug Resistance; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents; D000069285:Infliximab; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D009887:Ophthalmoscopy; D011446:Prospective Studies; D012449:Safety; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000276:immunology; D015866:Uveitis, Posterior / Q000188:drug therapy*
D000911:Antibodies, Monoclonal; D007166:Immunosuppressive Agents; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab