Infliximab-induced demyelination causes visual disturbance mistaken for recurrence of HLA-B27-related uveitis.
OBJECTIVE
To report a patient treated with infliximab for ankylosing spondylitis and HLA-B27 uveitis presenting with a scotoma in his left good eye due to infliximab-induced occipital demyelination mistaken for a uveitis recurrence.


METHODS
Case report.


METHODS
Review of clinical features, visual field, and investigational procedures.


RESULTS
Loss of visual function could not be explained by mere ophthalmic examination. Magnetic resonance imaging showed several demyelinating lesions, explaining the patient's symptoms and signs. Infiliximab was discontinued and the scotoma disappeared.


CONCLUSIONS
This is the first report of infliximab-induced demyelination producing ocular symptoms and signs in a patient treated for uveitis.
Papadia
Marina
M
Centre for Specialized Ophthalmic Care (COS), Lausanne, Switzerland.
Herbort
Carl Peter
CP
D000328:Adult; D000792:Angiography; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D004396:Coloring Agents; D003711:Demyelinating Diseases / Q000139:chemically induced* / Q000175:diagnosis; D003951:Diagnostic Errors; D005451:Fluorescein Angiography; D015796:HLA-B27 Antigen / Q000276:immunology*; D006801:Humans; D007208:Indocyanine Green; D000069285:Infliximab; D008279:Magnetic Resonance Imaging; D008297:Male; D009778:Occipital Lobe / Q000473:pathology; D012008:Recurrence; D012607:Scotoma / Q000175:diagnosis / Q000503:physiopathology; D013167:Spondylitis, Ankylosing / Q000188:drug therapy*; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors; D014605:Uveitis / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology*; D014786:Vision Disorders / Q000139:chemically induced* / Q000503:physiopathology; D014794:Visual Fields
D000911:Antibodies, Monoclonal; D004396:Coloring Agents; D015796:HLA-B27 Antigen; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D007208:Indocyanine Green