Abstract
Purpose: :
To report patients who experienced their first episode of uveitis while being treated with anti–Tumor Necrosis factor ( anti–TNF) therapy for systemic disease
Methods: :
Retrospective study of patients in a referral center for uveitis. Patients were included if their first attack of uveitis occurred after the onset of anti TNF–treatment.
Results: :
Five patients (three men and two women) were included. The mean age of patients was 37.8 years (range 19–58 years). Four patients had a diagnosis of ankylosing spondylitis and one patient was followed for rheumatoid arthritis. Treatment was by etanercept in four patients and by infliximab in one case, with no adverse reactions to treatment reported. In all cases, treatment successfully controlled the systemic manifestations of their disease. Uveitis was unilateral in four cases and bilateral in one case. All cases were acute, anterior, non granulomatous, uveitis. A cystoid macular edema was seen in both eyes of one patient. The mean visual acuity at onset was 0.64 (range CF–1.0). The mean time interval between diagnosis of the systemic disease and the episode of uveitis was 15.6 years (range 5–32 years). The mean time interval between the onset of anti–TNF treatment and uveitis was 11.5 months (range 0.5–23 months). No infectious cause of uveitis was found.
Conclusions: :
First attacks of uveitis were observed in anti–TNF treated patients. These attacks could be linked to systemic diseases, but paradoxical reactions to anti TNF therapy could also be considered.
Keywords: uveitis-clinical/animal model • drug toxicity/drug effects • autoimmune disease