a Rheumatology Division , Hospital Universitario Marqués de Valdecilla, IDIVAL, University of Cantabria , Santander, Spain.
b Rheumatology and Ophthalmology Divisions , Hospital Clinico Universitario San Carlos , Madrid, Spain.
Ocul Immunol Inflamm. 2017 Oct;25(5):604-609. doi: 10.1080/09273948.2016.1231331. Epub 2016 Oct 11.
To evaluate tocilizumab (TCZ) efficacy in severe and refractory birdshot chorioretinopathy (BSCR).
Assessment of BSCR patients refractory to conventional immunosuppressive and anti-TNF-α drugs who underwent TCZ therapy.
Two HLA-A29 positive patients (man/37 years and woman/38 years; four affected eyes) with BSCR were studied. They had a chronic bilateral posterior uveitis. Patient 1 had been treated with intraocular and oral corticosteroids, cyclosporine A, and infliximab whereas Patient 2 received intravenous methylprednisolone pulses, cyclosporine A, azathioprine, and adalimumab. At TCZ onset they had macular edema (four eyes); visual acuity (VA) impairment (four eyes); vitritis (one eye); and diffuse angiographic signs of vasculitis (periphlebitis) (two eyes). Improvement of VA and OCT was observed following TCZ therapy in both patients. After a follow-up of 18 months (Patient 1) and 10 months (Patient 2), respectively, a corticosteroid sparing effect without any adverse effects was achieved in both cases.
TCZ was effective in two patients with BSCR refractory to anti-TNF-α agents.
评估托珠单抗（TCZ）在严重和难治性鸟枪弹样脉络膜视网膜病变（BSCR）中的疗效。
评估对常规免疫抑制和抗 TNF-α药物治疗反应不佳的 BSCR 患者接受 TCZ 治疗的情况。
研究了 2 名 HLA-A29 阳性（男性/37 岁，女性/38 岁；4 只受累眼）的 BSCR 患者。他们患有慢性双侧后部葡萄膜炎。患者 1 曾接受眼内和口服皮质类固醇、环孢素 A 和英夫利昔单抗治疗，而患者 2 接受了静脉注射甲基泼尼松龙脉冲、环孢素 A、硫唑嘌呤和阿达木单抗治疗。在 TCZ 治疗开始时，他们有黄斑水肿（4 只眼）；视力（VA）受损（4 只眼）；眼内炎（1 只眼）；和弥漫性血管炎的血管造影征象（睫状缘炎）（2 只眼）。在 TCZ 治疗后，两名患者的 VA 和 OCT 均有所改善。在分别随访 18 个月（患者 1）和 10 个月（患者 2）后，两名患者均实现了皮质类固醇的节省效应，且无任何不良反应。
TCZ 对 2 名对 TNF-α 药物治疗反应不佳的 BSCR 患者有效。
