June 2020
Volume 61, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2020
Impact of immunomodulatory and immunosuppressive treatments on recurrence of multiple sclerosis-related uveitis.
Author Affiliations & Notes
  • Thomas Sales De Gauzy
    Ophthalmology, Pitié Salepêtrière, PARIS, France
    Ophthalmology, CHU TOULOUSE PURPAN, TOULOUSE, France
  • Fanny Varenne
    Ophthalmology, CHU TOULOUSE PURPAN, TOULOUSE, France
  • vincent soler
    Ophthalmology, CHU TOULOUSE PURPAN, TOULOUSE, France
  • Bahram Bodaghi
    Ophthalmology, Pitié Salepêtrière, PARIS, France
  • Priscille OLLE
    Ophthalmology, CHU TOULOUSE PURPAN, TOULOUSE, France
  • DAMIEN BIOTTI
    Neurology, CHU TOULOUSE PURPAN, TOULOUSE, France
  • Footnotes
    Commercial Relationships   Thomas Sales De Gauzy, None; Fanny Varenne, None; vincent soler, None; Bahram Bodaghi, None; Priscille OLLE, None; DAMIEN BIOTTI, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 5349. doi:
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      Thomas Sales De Gauzy, Fanny Varenne, vincent soler, Bahram Bodaghi, Priscille OLLE, DAMIEN BIOTTI; Impact of immunomodulatory and immunosuppressive treatments on recurrence of multiple sclerosis-related uveitis.. Invest. Ophthalmol. Vis. Sci. 2020;61(7):5349.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Few data are available regarding the optimal treatment of multiple sclerosis (MS)-related uveitis.The aim of this study is to evaluate the impact of multiple sclerosis (MS) treatment and conventional immunosuppressive therapies on the recurrence rate of uveitis associated with MS.

Methods : We conducted a retrospective, bicentric observational study of all patients with MS with at least one uveitis in two centres (May 2010-May 2019). Exclusion criteria were other cause of uveitis and follow-up less than 12 months. Treatment were divided into three groups : group 1 (first-line MS treatment ): interferon β, glatiramer acetate, dimethyl-fumarate, teriflunomide; group 2 ( second-line MS treament except fingolimod because of risk of macular edema) : natalizumab, anti-CD20 ; group 3 (conventional immunosuppressive therapies) : azathioprine, mycophenolate mofetil, methotrexate, cyclophosphamide. The primary endpoint was the number of ocular attacks per year during treatment compared to the pre-treatment period for each treament group, each patient was his or her own control. Characteristics of uveitis and treatment were reviewed.

Results : Forty-four patients were included. Patients were followed for 7,91 years (mean) before treament versus 2,92 years during treatment. Typically, uveitis was bilateral (77%), chronic (68%) and intermediate (80%). Cystoid macular edema occured in 13 patients (30%). Besides local treatment, uveitis was managed with systemic steroids (57%), intravitreal steroids (14%) and immunosuppressants (25%). Twenty-four patients received at least one treatment of group 1, 17 of group 2 and 14 of group 3. The frequency of ocular attacks per year decreased in the 3 groups during the treatment period from 0.82 ± 1.07 to 0.12 ± 0.36 in group 1; from 0.77 ± 0.52 to 0.09 ± 0.34 in group 2; from 1.58 ± 2.36 to 0.14 ± 0.27 in group 3 (all p <0.05).

Conclusions : MS treatment, excluding fingolimod, are associated with a decrease in frequency of uveitis recurrence. These results are reassuring for their use in patients with uveitis and support a potential combined neurological and ocular effect.

This is a 2020 ARVO Annual Meeting abstract.

 

Mean frequency of ocular attacks per year before treatment (white bar) and during treatment (black bar) in groups 1, 2 and 3. Error bars show standard deviations. *Significant difference P < 0.05.

Mean frequency of ocular attacks per year before treatment (white bar) and during treatment (black bar) in groups 1, 2 and 3. Error bars show standard deviations. *Significant difference P < 0.05.

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