April 2014
Volume 55, Issue 13
ARVO Annual Meeting Abstract  |   April 2014
Clinic & Treatment of Tubulo-Interstitial Nephritis and Uveitis Syndrome (TINU)
Author Affiliations & Notes
  • Tarek Bayyoud
    Ophthalmology, Eberhard-Karls-University, Tuebingen, Germany
  • Christoph M E Deuter
    Ophthalmology, Eberhard-Karls-University, Tuebingen, Germany
  • Bianka Sobolewska
    Ophthalmology, Eberhard-Karls-University, Tuebingen, Germany
  • Manfred Zierhut
    Ophthalmology, Eberhard-Karls-University, Tuebingen, Germany
  • Footnotes
    Commercial Relationships Tarek Bayyoud, None; Christoph Deuter, None; Bianka Sobolewska, None; Manfred Zierhut, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 5316. doi:
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      Tarek Bayyoud, Christoph M E Deuter, Bianka Sobolewska, Manfred Zierhut; Clinic & Treatment of Tubulo-Interstitial Nephritis and Uveitis Syndrome (TINU). Invest. Ophthalmol. Vis. Sci. 2014;55(13):5316.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose: To study complications and therapy of patients with Tubulointerstitial nephritis and uveitis (TINU) syndrome over a prolonged period.

Methods: Retrospective observational study of 9 patients with TINU-Sydrome. All patients had standardized clinical and ophthalmological assessments. Diagnosis of TINU was confirmed via beta-2 microglobuline determination in urine (n= 8) and/or renal biopsy (n= 1).

Results: Nine patients (5 female and 4 male) with TINU-Syndrome were followed up for a mean of 44.1 months (range 6-113 months). The mean age at diagnosis was 16.7 years (range 9-43 years). The anatomical diagnosis was bilateral anterior (5 patients), intermediate (3 patients) and panuveitis (1 patient). Complications involved were increased intraocular pressure due to a response to steroids (1 patient), development of optic disc edema (2 patients) and cystoid macular edema (2 patients). The treatment consisted in a stepladder approach beginning with local steroids (9 patients), systemic steroids (7 patients), immunosuppression (2x MTX, 1x Mycophenolic acid and 1x Mycophenolate mofetil) and anti-TNF alpha blocking agents (adalimumab; 2 patients). The number of relapses ranged between 0 and 7 (mean 1.9; 0: n= 2, 1-3: n= 6, 7: n= 1). The response to the final, adjusted regimen was quite acceptable and the patients could have been kept in prolonged periods of remission.

Conclusions: In this study, analyzing the course of TINU patients for a prolonged period, we found 3 of 9 patients with intermediate uveitis and also one patient with panuveitis. Topical and/ or systemic corticosteroids were effective in 5 patients, while 4 received immunosuppression or biologicals. In our study TINU was characterized by reduced responsiveness to corticosteroid therapy and less by severe complications.

Keywords: 746 uveitis-clinical/animal model • 487 corticosteroids • 555 immunomodulation/immunoregulation  

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