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A. Adan Civera, L. Pelegrin, V. Llorens, M. Mesquida, M. Hernandez, G. Espinosa, R. Cervera, R. Sanmartí; Early Infliximab Therapy for Sight-Threatening Posterior Uveitis. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5865.
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Our objective was to determine the efficacy of early infliximab (INF) treatment and outcomes in patients with sight-threatening posterior uveitis
5 patients with sight-threatening posterior uveitis refractory to oral glucocorticoids (GC) were treated with INF (at a dose of 5 mg/kg/iv at 0, 2, 6 and every 8 weeks thereafter), for a minimum of 12 months. In those patients that showed a good response to INF, therapy with GC was progressively discontinued. When remission was achieved and maintained during at least six months, INF was discontinued and patients were subsequently evaluated monthly. Main outcome measure were:number and severity of relapses of posterior uveitis ,reduction of corticosteroid,best corrected visual acuity (BCVA) and foveal thickness measured by optical coherence tomography (OCT) in cases of macular edema
Four out of 5 patients (80%) achieve remission and therapy with GC and INF were discontinued in a progressive form. Of the five patients, three were female; mean age was 31 years (range 25-38) and the mean follow-up was 20,8 months (range 12-24). Two patients had posterior uveitis associated with Behçet disease, 1 diffuse subretinal fibrosis syndrome, 1 idiopathic posterior uveitis and 1 punctate inner chorioretinopathy . Mean INF treatment was 13 infusions (range 9-18). Two out of 5 patients ( 40% ) remained in complete remission with no relapses during the follow-up, and are currently without therapy. Treatment with adalimumab 40-mg was required in three patients due to relapsing after withdrawal of the infusions. At the last examination ,visual acuity was improved in 7 eyes (70%) ,stable in 3 (30%) , and worse in 0 (0 %) eyes.
In this small series of eyes with long-term follow-up , early infliximab therapy for posterior sight-threatening uveitis was found to be safe and showed favourable visual outcomes.
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