Infliximab for chronic cystoid macular edema associated with uveitis.
OBJECTIVE
To assess the efficacy of the anti-TNF monoclonal antibody infliximab in uveitis patients without clinically evident ocular inflammation and impaired visual acuity because of chronic cystoid macular edema (CME).


METHODS
Prospective, noncomparative, interventional case series.


METHODS
Patients with refractory CME (14 eyes, mean duration of 14 months), associated with intermediate uveitis (n = 6), Adamantiades-Behcet disease (n = 2), adult-type vascular pseudotumor (n = 1), and HLAB27+-related uveitis (n = 1) received an intravenous infliximab infusion (5 mg/kg); five patients were retreated after 1 month.


RESULTS
Macular thickness, measured by ocular coherence tomography, was reduced from 428 +/- 138 microm to 219 +/- 51 microm at 2 months postbaseline (P = .0001), while visual acuity increased from 0.41 +/- 0.18 to 0.83 +/- 0.17 (P < .00001). Anatomic and functional improvement was sustained at 6 months in all. No ocular or extra-ocular side effects were noted.


CONCLUSIONS
These promising results suggest that TNF may play an important pathogenetic role in chronic CME, thus, a controlled trial is warranted.
Ocular Inflammation and Immunology Service, Department of Ophthalmology, Laikon Hospital, Athens University Medical School, Athens, Greece.
Nikos N
NN
Markomichelakis
Panagiotis G
PG
Theodossiadis
Eygenia
E
Pantelia
Semina
S
Papaefthimiou
George P
GP
Theodossiadis
Petros P
PP
Sfikakis
D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D000069285:Infliximab; D007262:Infusions, Intravenous; D008269:Macular Edema / Q000175:diagnosis / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D041623:Tomography, Optical Coherence; D014409:Tumor Necrosis Factor-alpha / Q000627:therapeutic use; D014605:Uveitis / Q000175:diagnosis / Q000188:drug therapy*; D014792:Visual Acuity
D000911:Antibodies, Monoclonal; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab