Optic neuritis associated with adalimumab in the treatment of uveitis.
BACKGROUND
Tumor necrosis factor (TNF) inhibitors such as adalimumab are increasingly used in the treatment of ocular inflammatory disease refractory to standard therapies. There is evidence that TNF inhibitors are associated with demyelinating neurologic events.


OBJECTIVE
The authors report a case of optic neuritis and multiple sclerosis developing in association with the use of adalimumab for the treatment of bilateral chronic granulomatous iridocyclitis and multifocal choroiditis. They also review the available literature on cases of optic neuritis occurring in the setting of TNF inhibition.


RESULTS
The authors identified 21 cases of optic neuritis associated with TNF inhibition; 36% of cases with available MRI results had evidence of other demyelinating lesions in the CNS.


CONCLUSIONS
The strong association between TNF inhibitors and CNS demyelination may represent an adverse effect of these drugs. Ophthalmologists should recognize the relationship between TNF inhibitors and demyelinating disease, as it can present initially with visual symptoms.
Li
Sing Your
SY
Department of Ophthalmology and Visual Sciences, University of Illinois, Chicago, Illinois, USA. Singli03@gmail.com
Birnbaum
Andrea D
AD
Goldstein
Debra A
DA
D000068879:Adalimumab; D000276:Adjuvants, Immunologic / Q000627:therapeutic use; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000009:adverse effects* / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000009:adverse effects* / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D001921:Brain / Q000473:pathology; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D000068556:Interferon beta-1a; D016899:Interferon-beta / Q000627:therapeutic use; D015863:Iridocyclitis / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008775:Methylprednisolone / Q000008:administration & dosage; D009103:Multiple Sclerosis / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D009902:Optic Neuritis / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors; D014605:Uveitis / Q000188:drug therapy*; D014794:Visual Fields
D000276:Adjuvants, Immunologic; D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D014409:Tumor Necrosis Factor-alpha; D016899:Interferon-beta; D000068879:Adalimumab; D008775:Methylprednisolone; D000068556:Interferon beta-1a