April 2010
Volume 51, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2010
Ocular and Systemic Safety of Intravitreal TNF Inhibitors: A Pilot Study From the Pan American Collaborative Retina Study (PACORES) Group
Author Affiliations & Notes
  • E. Hernandez-Bogantes
    Vitreo-Retinal, Instituto de Cirugia Ocular, Heredia, Costa Rica
  • L. Wu
    Vitreoretinal, Instituto De Cirugia Ocular, San Jose, Costa Rica
  • J. Roca
    Vitreo-Retinal, Clinica Ricardo Palma, Lima, Peru
  • J. F. Arevalo
    Retina and Vitreous, Clinica Oftal Centro Caracas, Caracas, Venezuela
  • K. Barraza
    Vitreo-Retinal, Clinica Ricardo Palma, Lima, Peru
  • A. F. Lasave
    Vitreo-Retinal, Clinica Oftalmologica Centro Caracas, Caracas, Venezuela
  • Pan American Collaborative Retina Study Group
    Vitreo-Retinal, Instituto de Cirugia Ocular, Heredia, Costa Rica
  • Footnotes
    Commercial Relationships  E. Hernandez-Bogantes, None; L. Wu, None; J. Roca, None; J.F. Arevalo, None; K. Barraza, None; A.F. Lasave, None.
  • Footnotes
    Support  None.
Investigative Ophthalmology & Visual Science April 2010, Vol.51, 4749. doi:
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      E. Hernandez-Bogantes, L. Wu, J. Roca, J. F. Arevalo, K. Barraza, A. F. Lasave, Pan American Collaborative Retina Study Group; Ocular and Systemic Safety of Intravitreal TNF Inhibitors: A Pilot Study From the Pan American Collaborative Retina Study (PACORES) Group. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4749.

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

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Abstract

Purpose: : To report the ocular and systemic adverse events following intravitreal injections of 2 different tissue necrosis factor (TNF) inhibitors in eyes with a variety of retinal disorders.

Methods: : Retrospective multicenter interventional study of eyes treated with either intravitreal infliximab or adalimumab.

Results: : A total of 54 eyes received 72 injections of infliximab (n=24 injected with 1 mg and n=30 injected with 2 mg). Fourteen eyes were injected 17 times with 2 mg of adalimumab. There were no systemic adverse events such as neuropathy, granulomatous infections or lymphoma reported in this cohort of patients. Thirteen eyes (24.1%) injected with infliximab developed a severe granulomatous uveitic reaction. Four (30.8%) of these eyes required pars plana vitrectomy. The uveitis resolved in the remaining 9 eyes with intensive topical steroids. The inflammatory reaction appears to be a dose related effect as all the uveitis ocurred in eyes injected with 2 mg of infliximab and none in the 1 mg of infliximab. Four (13.3%) eyes injected with 2 mg of infliximab developed ocular hypertension. In 2 eyes the elevated intraocular pressure was associated to the uveitic response and resolved upon resolution of the inflammatory reaction. In the other 2, the elevated intraocular pressure was temporary and resolved with topical hypotensive agents. None of the eyes injected with adalimumab exhibited ocular adverse events.

Conclusions: : Intravitreal injections of adalimumab appear to be well tolerated in the short term. Intravitreal injections of infliximab may elicit a severe intraocular inflammatory reaction that appears to be dose related.

Keywords: retina • drug toxicity/drug effects • injection 
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