阿达木单抗治疗与鸟枪弹样脉络膜视网膜病变相关的难治性黄斑囊样水肿
Adalimumab in refractory cystoid macular edema associated with birdshot chorioretinopathy.
作者信息
Steeples Laura R, Spry Paul, Lee Richard W J, Carreño Ester
机构信息
Bristol Eye Hospital, University Hospitals Bristol NHS Foundation Trust, Lower Maudlin Street, Bristol, BS1 2LX, UK.
Faculty of Medicine and Dentistry, School of Clinical Sciences, University of Bristol, Bristol, UK.
出版信息
Int Ophthalmol. 2018 Jun;38(3):1357-1362. doi: 10.1007/s10792-017-0592-5. Epub 2017 Jun 12.
PURPOSE
To report the clinical outcomes of adalimumab therapy in cases of birdshot chorioretinitis (BCR) with cystoid macular edema (CME) refractory to conventional immunotherapy.
METHODS
This is a retrospective case series of three BCR patients treated with adalimumab for refractory CME. The main outcome measure was central subfield thickness (CST) on optical coherence tomography. Any patients treated with local steroids and/or receiving systemic steroids higher than 40 mg prednisolone daily during adalimumab therapy were excluded.
RESULTS
At baseline, all patients were receiving systemic corticosteroids and two second-line immunosuppressive agents. The mean duration of treatment with adalimumab was 31.2 months (range 17.2-52). The mean CST was 327 ± 112.7 μm (mean ± SD) at baseline and 256.2 ± 39.7 μm at 6 months and 235.5 ± 32.5 μm at 12 months. Adalimumab permitted cessation or reduction in the daily dose of oral prednisolone plus withdrawal of a second-line agent in all patients.
CONCLUSIONS
In these patients, adalimumab was effective in the treatment of refractory CME.
目的
报告阿达木单抗治疗对传统免疫疗法难治的鸟枪弹样脉络膜视网膜病变（BCR）合并黄斑囊样水肿（CME）的临床疗效。
方法
这是一项回顾性病例系列研究，纳入3例接受阿达木单抗治疗难治性CME的BCR患者。主要观察指标为光学相干断层扫描测量的中心子野厚度（CST）。排除在阿达木单抗治疗期间接受局部类固醇治疗和/或每日接受高于40mg泼尼松龙全身类固醇治疗的任何患者。
结果
基线时，所有患者均接受全身皮质类固醇和两种二线免疫抑制剂治疗。阿达木单抗的平均治疗时长为31.2个月（范围17.2 - 52个月）。基线时平均CST为327±112.7μm（均值±标准差），6个月时为256.2±39.7μm，12个月时为235.5±32.5μm。阿达木单抗使所有患者能够停止或减少口服泼尼松龙的每日剂量，并停用一种二线药物。
结论
在这些患者中，阿达木单抗对难治性CME的治疗有效。
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