Özdemir Yalçınsoy Kübra, Özen Osman, Özdamar Erol Yasemin, Çakar Özda Pınar
University of Health Sciences Türkiye, Ulucanlar Eye Training and Research Hospital, Clinic of Ophthalmology, Ankara, Türkiye.
Kastamonu Training and Research Hospital, Clinic of Ophthalmology, Kastamonu, Türkiye.
Turk J Ophthalmol. 2024 Dec 31;54(6):337-343. doi: 10.4274/tjo.galenos.2024.70371.
To evaluate the clinical features of pediatric non-infectious uveitis (NIU) patients treated with adalimumab (ADA) and the efficacy of ADA in patients unresponsive to conventional immunosuppressive therapy.
The records of 91 NIU patients aged ≤16 years who received ADA therapy were evaluated retrospectively. The patients' demographic and clinical characteristics and treatment approaches were recorded. The efficacy of ADA in patients treated for at least 1 year after failure of conventional immunosuppressive treatment was evaluated by comparing the best corrected visual acuity (BCVA), severity of intraocular inflammation, uveitis flare-ups, topical and systemic corticosteroid (CS) use, and central macular thickness (CMT) values before and after ADA treatment.
The study included 103 eyes of 53 patients, of whom 29 (54.7%) were female. The mean age at presentation was 8.2±3.4 (range: 3-16) years. The mean follow-up period was 41.6±28.2 (range: 18-120) months. Twenty-six patients (49.0%) had anterior uveitis, 22 (41.5%) had intermediate uveitis, and 5 (9.4%) had panuveitis. The mean duration of ADA treatment was 23.0±13.7 (range: 12-60) months. Uveitis flare-ups developed in only 13 patients (24.5%) while on ADA treatment. When pre- and post-treatment periods were compared, the mean number of uveitis flare-ups, intraocular inflammation severity, mean dose of topical and systemic CS, and mean CMT values were significantly lower in the post-treatment period (p<0.05). The mean BCVA was significantly improved after 6 and 12 months of ADA treatment compared to the pre-treatment visual acuity (p<0.05).
ADA effectively controlled intraocular inflammation, reducing the need for systemic and topical CS and improving visual outcomes in pediatric NIU.
评估接受阿达木单抗（ADA）治疗的儿童非感染性葡萄膜炎（NIU）患者的临床特征，以及ADA对常规免疫抑制治疗无效患者的疗效。
回顾性评估91例年龄≤16岁接受ADA治疗的NIU患者的病历。记录患者的人口统计学和临床特征以及治疗方法。通过比较ADA治疗前后的最佳矫正视力（BCVA）、眼内炎症严重程度、葡萄膜炎复发情况、局部和全身皮质类固醇（CS）的使用情况以及中心黄斑厚度（CMT）值，评估ADA对常规免疫抑制治疗失败后至少治疗1年的患者的疗效。
该研究纳入了53例患者的103只眼，其中29例（54.7%）为女性。就诊时的平均年龄为8.2±3.4（范围：3 - 16）岁。平均随访期为41.6±28.2（范围：18 - 120）个月。26例（49.0%）患者患有前葡萄膜炎，22例（41.5%）患有中间葡萄膜炎，5例（9.4%）患有全葡萄膜炎。ADA治疗的平均持续时间为23.0±13.7（范围：12 - 60）个月。在接受ADA治疗期间，仅13例患者（24.5%）出现葡萄膜炎复发。比较治疗前和治疗后阶段，治疗后阶段葡萄膜炎复发的平均次数、眼内炎症严重程度、局部和全身CS的平均剂量以及平均CMT值均显著降低（p<0.05）。与治疗前视力相比，ADA治疗6个月和12个月后平均BCVA显著改善（p<0.05）。
ADA有效控制眼内炎症，减少全身和局部CS的使用需求，并改善儿童NIU的视力预后。
