Joseph Annie, Raj Dev, Dua Harminder S, Powell Pauline T, Lanyon Peter C, Powell Richard J
Department of Ophthalmology and Visual Sciences, B Floor, Eye and ENT Block, Queen's Medical Centre, Nottingham NG7 2UH, United Kingdom.
Ophthalmology. 2003 Jul;110(7):1449-53. doi: 10.1016/S0161-6420(03)00406-8.
To determine the efficacy and safety of infliximab in the treatment of refractory posterior uveitis.
Noncomparative interventional case series.
Five patients with posterior uveitis were treated: 3 had Behçet's syndrome, and 2 had idiopathic posterior uveitis.
Patients with sight-threatening uveitis refractory to other immunosuppressive agents were treated with infliximab.
Intraocular inflammation, by using binocular indirect ophthalmoscopy score, retinal vasculitis, and visual acuity. Adverse effects of infliximab were documented.
Within 2 weeks of the first infusion of infliximab, 4 of 5 patients showed marked improvement in vitreous haze and visual acuity. By the 6-month follow-up, the same four patients had achieved remission of posterior uveitis and had successfully withdrawn all other immunosuppressive therapy. Further infusions of infliximab were required in 3 patients. One patient developed ocular and systemic tuberculosis, which responded to antituberculous treatment.
Infliximab is effective in the treatment of sight-threatening refractory posterior uveitis. However, patients should be thoroughly screened for tuberculosis before treatment and followed up closely during and after therapy with infliximab.
确定英夫利昔单抗治疗难治性后葡萄膜炎的疗效和安全性。
非对照性干预病例系列。
5例后葡萄膜炎患者接受治疗：3例患有白塞病，2例患有特发性后葡萄膜炎。
对视力受威胁且对其他免疫抑制剂治疗无效的葡萄膜炎患者使用英夫利昔单抗进行治疗。
通过双眼间接检眼镜评分、视网膜血管炎和视力评估眼内炎症情况。记录英夫利昔单抗的不良反应。
首次输注英夫利昔单抗后2周内，5例患者中有4例玻璃体细胞混浊和视力有显著改善。到6个月随访时，同样这4例患者的后葡萄膜炎已缓解，并成功停用了所有其他免疫抑制治疗。3例患者需要进一步输注英夫利昔单抗。1例患者发生眼内和全身性结核，对抗结核治疗有效。
英夫利昔单抗治疗视力受威胁的难治性后葡萄膜炎有效。然而，治疗前应全面筛查患者是否患有结核，且在英夫利昔单抗治疗期间及治疗后应密切随访。
