Yargi-Ozkocak Berru, Altan Cigdem, Kemer-Atik Burcu, Balci Ali Safa, Basarir Berna
Beyoglu Eye Training and Research Hospital, University of Health Sciences Turkey, Istanbul, Turkey.
Ocul Immunol Inflamm. 2025 Apr;33(3):358-366. doi: 10.1080/09273948.2024.2359002. Epub 2024 Jun 3.
BACKGROUND/OBJECTIVES: To investigate the long-term efficacy and safety of adalimumab(ADA) in the treatment of patients with serpiginous choroiditis (SC) refractory to conventional therapy through quantitative parameters.
SUBJECTS/METHODS: A retrospective analysis was conducted on patients diagnosed with SC clinically and through fundus autofluorescence(FAF). Patients receiving ADA treatment were included. Demographic and clinical characteristics of the patients, association with tuberculosis (TB) infection, number of immunosuppressive therapies, recurrences, best corrected visual acuity (BCVA) change, and ADA-related side effects were recorded. The progression rate before and after ADA was calculated based on the area involved by FAF.
Sixteen eyes of 8 patients (3 female/5 male) were enrolled to the study. The median (IQR) age was 53.5 (16.5) years. Diagnosis was SC in 4, ampiginous choroiditis in 3, and TB-related serpiginous-like choroiditis in 1 patient. Peripapillary involvement was present in 10 of 16 eyes. The area involved by FAF continued to progress under ADA treatment, however the progression rate was decreased ( = 0.143).The BCVA was preserved ( = 0.772). The number of systemic and local treatments decreased with ADA ( = 0.025 and 0.019, respectively). Additionally, the number of recurrences was reduced with ADA ( = 0.002). Median (IQR) follow-up was 45(28.75) months. Two patients experienced ADA-related side effects (pulmonary TBand rash).
Our findings suggest a promising role for ADA in halting the progression of SC and have implications for improving outcomes. Despite the evidence in the literature at the level of case reports, ADA can be used effectively with close monitoring for potential risks.
背景/目的：通过定量参数研究阿达木单抗（ADA）治疗对传统治疗无效的匐行性脉络膜炎（SC）患者的长期疗效和安全性。
受试者/方法：对临床诊断为SC并经眼底自发荧光（FAF）检查确诊的患者进行回顾性分析。纳入接受ADA治疗的患者。记录患者的人口统计学和临床特征、与结核（TB）感染的相关性、免疫抑制治疗次数、复发情况、最佳矫正视力（BCVA）变化以及ADA相关副作用。根据FAF累及面积计算ADA治疗前后的进展率。
8例患者（3例女性/5例男性）的16只眼纳入研究。中位（四分位间距）年龄为53.5（16.5）岁。诊断为SC的有4例，匐行性脉络膜炎的有3例，结核相关匐行性脉络膜样炎的有1例。16只眼中有10只存在视乳头周围受累。在ADA治疗下，FAF累及面积仍持续进展，但进展率降低（=0.143）。BCVA得以保留（=0.772）。使用ADA后全身和局部治疗次数减少（分别为=0.025和0.019）。此外，使用ADA后复发次数减少（=0.002）。中位（四分位间距）随访时间为45（28.75）个月。2例患者出现ADA相关副作用（肺结核和皮疹）。
我们的研究结果表明ADA在阻止SC进展方面具有潜在作用，并对改善治疗结果具有重要意义。尽管文献中仅有病例报告层面的证据，但ADA在密切监测潜在风险的情况下可有效使用。
