Abstract
Purpose::
To show a case of optic neuropathy intolerant of steroids successfully treated with infliximab.
Methods::
The records of a 68 year old patient with temporal pain, jaw claudication and visual loss treated with infliximab were reviewed.
Results::
Visual fields normalized and symptoms immediately improved.
Conclusions::
Infliximab is an indirect T cell inhibitor. It is a mouse-human IgG1 chimeric anti-tumor necrosis (TNFa) factor monoclonal antibody. It inhibits the binding of TNFa with its receptor. TNFa induces interleukin 1 and 6 which in turn lead to T cell migration. As giant cell arteritis is a T cell mediated disease, infliximab may offer a way to arrest visual loss in emergent giant cell arteritis, as its response may occur within hours.
Keywords: neuro-ophthalmology: optic nerve • immunomodulation/immunoregulation • ischemia