June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
Impact on Leakage Measured by Ultra-Widefield Fluorescein Angiography Following Adalimumab Therapy in Pediatric Uveitis Patients
Author Affiliations & Notes
  • Jasmin Kaur Bhangu
    Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, United States
  • Sumit Sharma
    Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, United States
  • Abel Hamdan
    Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, United States
  • Kimberly Baynes
    Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, United States
  • Danielle X Burton
    Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, United States
  • Cindy Chen
    Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, United States
  • Jon Whitney
    Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, United States
  • Careen Lowder
    Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, United States
  • Justis P Ehlers
    Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, United States
  • Sunil K Srivastava
    Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, United States
  • Footnotes
    Commercial Relationships   Jasmin Bhangu None; Sumit Sharma AbbVie, Allergan, Eyepoint, Clearside, Bausch and Lomb, Genentech, Regeneron, Regenxbio, Apellis, Genentech, Roche, IONIS, Santen, Gilead, Code C (Consultant/Contractor); Abel Hamdan None; Kimberly Baynes None; Danielle Burton None; Cindy Chen None; Jon Whitney None; Careen Lowder None; Justis Ehlers Aerpio, Novartis, Zeiss, Alcon, Leica, Santen, Allergan, Genentech, Regeneron, Adverum, Allegro, Thrombogenics, Stealth, Code C (Consultant/Contractor), Aerpio, Boehringer-Ingelheim, Alcon, Allergan, Regeneron, Genentech, Thrombogenics, Novartis, Code F (Financial Support), Leica, Code P (Patent); Sunil Srivastava Novartis, Regeneron, Bausch and Lomb, Eyepoint, Eyevensys, Abbvie, Zeiss, Code C (Consultant/Contractor), Eyepoint, Regeneron, Allergan, Santen, Code F (Financial Support)
  • Footnotes
    Support  NIH-NEI P30 Core Grant and unrestricted grants from Research to Prevent Blindness, Inc. and the Cleveland Eye Bank Foundation
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 4854. doi:
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      Jasmin Kaur Bhangu, Sumit Sharma, Abel Hamdan, Kimberly Baynes, Danielle X Burton, Cindy Chen, Jon Whitney, Careen Lowder, Justis P Ehlers, Sunil K Srivastava; Impact on Leakage Measured by Ultra-Widefield Fluorescein Angiography Following Adalimumab Therapy in Pediatric Uveitis Patients. Invest. Ophthalmol. Vis. Sci. 2023;64(8):4854.

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

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Abstract

Purpose : To examine the utility of quantitative analysis of leakage on ultra-widefield fluorescein angiography (UWFA) as a correlate for clinical response in pediatric uveitis patients treated with adalimumab.

Methods : This is an IRB-approved, retrospective, consecutive case series. Inclusion criteria included pediatric patients diagnosed with non-infectious uveitis taking adalimumab with at least a 12-month follow-up period with UWFA imaging taken at multiple time points. A customized automated program was used to select the best quality late frame image. A semi-automated algorithm with manual correction was used to quantify leakage as a percent of retinal area. Patients were classified as treatment-responsive to adalimumab if they had improvement of disease on imaging with at least an 80% reduction in leakage by 12-month follow-up; patients were qualified successes if they had at least a 50% reduction in leakage by 12-month follow-up, as their improvement was not as complete as the treatment-responsive group. Patients were considered treatment-failures if they had recurrent or worsening disease at 12-months or were switched to a different medication due to having limited or no response. Leakage area and percent change in leakage over time were compared among treatment-responsive, qualified successes, and treatment-failure groups.

Results : A total of 76 eyes from 38 pediatric patients (24 female, 14 male) were included. Compared to baseline, 9 of 34 eyes (26%) were responsive to adalimumab at 3-months and 17 of 31 eyes (55%) were responsive at 6-months. At 12-months, 23 of 37 eyes (62%) were treatment-responsive, 6 of 37 eyes (16%) were qualified successes, 6 of 37 eyes (16%) were treatment-failures, and 2 eyes had no change as there was no leakage. At 12-months compared to baseline, treatment-responsive eyes had a 95% decrease in leakage, eyes classified as qualified successes had a 69% decrease in leakage, and treatment-failure eyes had a 130% increase in leakage.

Conclusions : By 6-months, greater than 50% of eyes were responsive to adalimumab and demonstrated a reduction in total retinal leakage compared to baseline. Quantitative analysis of leakage using UWFA has clinical utility in measuring response to adalimumab therapy among pediatric uveitis patients.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

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