Daclizumab for treatment of birdshot chorioretinopathy.
OBJECTIVE
To report the outcomes for daclizumab in the treatment of birdshot chorioretinopathy (BSCR) refractory to traditional immunomodulatory therapy (IMT).


METHODS
We retrospectively reviewed medical records of 8 patients with BSCR whose disease was refractory to or who were intolerant of traditional IMT. All patients received 1 mg/kg of daclizumab intravenously at 2-week intervals initially at 1 referral uveitis practice. Main outcome measures were changes in visual acuity, vitreous inflammation, fluorescein angiographic pathologic features, electroretinography (ERG) parameters, concomitant IMT requirements, and adverse events.


RESULTS
Over a mean follow-up of 25.6 months, 7 patients had either stabilization or improvement in visual acuity of both eyes and complete resolution of vitreous inflammation. Six patients had resolution of vasculitis on fluorescein angiography. The ERG 30-Hz implicit times and the bright scotopic amplitudes worsened in some patients despite abolition of clinically evident inflammation. Four patients were able to discontinue all other IMT and remain inflammation free while receiving only daclizumab treatment. Two patients developed adverse effects that led to daclizumab treatment discontinuation.


CONCLUSIONS
Daclizumab therapy was effective in stabilizing vision and decreasing inflammation in most patients with BSCR. The ERG parameters continued to decline in some patients despite adequate inflammatory control. Regular serologic monitoring is critical to detect adverse events.
Sobrin
Lucia
L
Massachusetts Eye Research and Surgery Institute, 5 Cambridge Center, Eighth Floor, Cambridge, MA 02142, USA.
Huang
John J
JJ
Christen
William
W
Kafkala
Chrysanthi
C
Choopong
Pitipol
P
Foster
C Stephen
CS
D000328:Adult; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D002825:Chorioretinitis / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D000077561:Daclizumab; D004596:Electroretinography; D005128:Eye Diseases / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D005451:Fluorescein Angiography; D015234:HLA-A Antigens / Q000032:analysis; D006801:Humans; D007074:Immunoglobulin G / Q000009:adverse effects / Q000627:therapeutic use*; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity; D014822:Vitreous Body / Q000187:drug effects* / Q000473:pathology / Q000503:physiopathology
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D015234:HLA-A Antigens; C035524:HLA-A29 antigen; D007074:Immunoglobulin G; D007166:Immunosuppressive Agents; D000077561:Daclizumab