title: Optic neuritis occurring with anti-tumour necrosis factor alpha therapy.
abstract: OBJECTIVE
  Various demyelinating disorders have been reported in association with anti-tumour necrosis factor alpha (TNFalpha) agents. The objective of this study was to review the occurrence, clinical features and outcome of optic neuritis (ON) during treatment with anti-TNFalpha agents.
  
  
  METHODS
  A PubMed search was conducted to identify literature addressing the potential association between anti-TNFalpha agents and ON, following our experience with a patient having rheumatoid arthritis in whom ON developed while being treated with infliximab.
  
  
  RESULTS
  15 patients including the case presented here with ON in whom the symptoms developed following TNFalpha antagonist therapy were evaluated. Eight of these patients had received infliximab, five had received etanercept and two patients had received adalimumab. Among them, nine patients experienced complete resolution, and two patients had partial resolution, while four patients continued to have symptoms.
  
  
  CONCLUSIONS
  Patients being treated with a TNFalpha antagonist should be closely monitored for the development of ophthalmological or neurological signs and symptoms. Furthermore, consideration should be given to avoiding such therapies in patients with a history of demyelinating disease. If clinical evaluation leads to the diagnosis of ON, discontinuation of the medication and institution of steroid treatment should be a priority.
authors: Gulhane Military School of Medicine, Division of Rheumatology, Ankara, Turkey.
authors: Ismail
authors: I
authors: Simsek
authors: Hakan
authors: H
authors: Erdem
authors: Salih
authors: S
authors: Pay
authors: Gungor
authors: G
authors: Sobaci
authors: Ayhan
authors: A
authors: Dinc
mesh_terms: D000068879:Adalimumab; D000293:Adolescent; D000328:Adult; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000188:drug therapy / Q000276:immunology; D000068800:Etanercept; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007074:Immunoglobulin G / Q000009:adverse effects / Q000627:therapeutic use; D000069285:Infliximab; D008297:Male; D008875:Middle Aged; D009902:Optic Neuritis / Q000139:chemically induced* / Q000188:drug therapy / Q000276:immunology; D011239:Prednisolone / Q000627:therapeutic use; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents; D005938:Glucocorticoids; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D011239:Prednisolone; D000069285:Infliximab; D000068879:Adalimumab; D000068800:Etanercept