Correlation of an Objective Fluorescein Angiography Inflammatory Scoring System with Visual and Anatomical Outcomes in Eyes with Non-Infectious Uveitis treated with Intravenous Tocilizumab

Abstract

Purpose : To report the correlation of an objective fluorescein angiography inflammatory scoring system with visual and anatomical outcomes in eyes with non-infectious intermediate, posterior or panuveitis being treated with intravenous infusions of tocilizumab.

Methods : STOP-Uveitis is a randomized, multi-center clinical trial that evaluated the role of tocilizumab (TCZ) in patients with non-infectious uveitis (NIU). 37 patients with NIU were randomized into one of two treatment groups to receive intravenous (IV) infusions of either 4mg/kg TCZ or 8mg/kg TCZ. Infusions were given every 4 weeks in both groups until month 6 (primary endpoint). Posterior segment inflammatory outcomes were assessed by evaluating fluorescein angiograms (FA) at baseline and month 6 visits. All images were graded by certified graders at a central reading center. A semi-quantitative, scoring system for FA was used to assess signs that represent ongoing inflammatory processes in the posterior segment. Changes in FA outcomes from baseline to month 6 were correlated with changes in central retinal thickness (CRT, as assessed by SD-OCT) and best corrected visual acuity (BCVA) during the study. Pearson correlation was used to assess the correlation between the different study parameters.

Results : 37 eyes (37 patients) were randomized in the STOP-Uveitis study. Mean change in BCVA, FA inflammatory score and CRT at month 6 have been reported in the Table. There was only a weak correlation between the FA inflammatory score and BCVA (r = 0.24), and CRT (r = 0.38) during the study. The correlation between CRT and BCVA was found to be comparatively higher (r = 0.60). No differences were observed between the two study groups.

Conclusions : TCZ (both 4 and 8 mg/kg) is effective in improving posterior segment inflammation, BCVA and CRT in eyes with non-infectious intermediate, posterior and pan-uveitis. However, improvement in the inflammatory score is not strongly correlated with improvement in vision or reduction in central retinal thickness in these eyes during the initial 6 months of therapy.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

 

Table – Change in visual, anatomical and inflammatory markers at Month 6.