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Keiko Fujii, Yoshihiko Usui, Chihiro Maehara, Kinya Tsubota, Ryosuke Mitsuhashi, Akihiko Umazume, Takeshi Kezuka, Jun-ichi Sakai, Hiroshi Goto; Efficacy of infliximab and adalimumab for macular edema associated with uveitis. Invest. Ophthalmol. Vis. Sci. 2019;60(9):3521. doi: https://doi.org/.
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The use of anti-tumor necrosis factor (TNF)-α agents for non-infectious uveitis has been increasing. Although the efficacy of anti-TNF-α agents for uveitis has been reported, reports on the effectiveness for macular edema associated with uveitis (MEAU) remain sparse. The aim of this study was to evaluate the efficacy of infliximab (IFX) and adalimumab (ADA) for the treatment of MEAU.
The medical records of all patients treated with IFX or ADA for MEAU between 2007 and 2018 were retrospectively reviewed. The date collected included gender, definite diagnosis, visual acuity (VA) before and after treatment with anti-TNF-α agents, treatments and its effectiveness before initiation of anti-TNF-α agents, central macular thickness (CMT) and the period between disease onset and initiation of anti-TNF-α agents.
Among 71 patients (140 eyes) in the IFX group and 44 patients (81 eyes) in the ADA group analyzed, 32 eyes and 17 eyes had MEAU, respectively. Mean VA (logMAR) improved from 0.73±0.62 to 0.40±0.54 in the IFX group (p < 0.05) and from 0.43±0.43 to 0.35±0.41 logMAR in the ADA group (p < 0.05), while mean CMT decreased from 504±132 to 332±146 μm and from 478±90 to 367±99 μm, respectively. CMT reduction of more than 20% was observed in 26 eyes (81.3%) in the IFX group and 13 eyes (76.5%) in the ADA group. While the efficacy did not differ depending on disease duration in the ADA group, early treatment initiation was significantly more effective in the IFX group (p = 0.0015). Eyes with baseline CMT more than 500 μm showed significant improvement only in the ADA group.
Both IFX and ADA were effective for MEAU, although many eyes did not show complete resolution of ME.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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