Optical coherence tomography biomarkers of individuals with uveitis on Adalimumab – preliminary data of a two year longitudinal analysis

Abstract

Purpose : A single center retrospective cohort study of individuals with uveitis on adalimumab injections was aimed at studying its impact on the optical coherence tomography features at presentation and studied longitudinally with the aim of studying control of inflammation.

Methods : The medical records of patients who consented to initiating adalimumab between 2017 to 2022 were reviewed. All patients who were initiated on treatment, and at a minimum, received the loading dose (80mg) of adalimumab were included in this study (n=309). All patients who had imaging at baseline, if possible at 6 months, 12 months and 24 months were included, with one eye either the worse eye or the eye where images were available being randomised in our study for statistical analysis (n=181). Exclusion criteria included lack of clarity in images and insufficient follow up. We studied predominantly the central retinal thickness(CRT) and subfoveal choroidal thickness(SFCT) on images obtained on Heidelberg Spectralis optical coherence tomography (OCT). Data was analysed using appropriate statistical tests.

Results : The mean age of patients in our study was 49.67 (±14.79) years. In our randomisation the right eye to left eye ratio (95:86) was equivalent. The mean CRT at baseline was 244.96 (± 116.73) microns in our study, which improved to 211.76 (± 89.38) microns over 2 years (p=0.0026). The mean SFCT at baseline was 333.27 (± 121.02) microns, and that improved to 288.35 (± 111.96) microns (p=0.0003). The change in CRT over the first 6 months (44.50 ± 112.50) was statistically similar to the change noted at 24 months (33.20 ± 102.07) (p=0.31). Similarly the change in the SFCT that happened over the first 6 months (58.15 ± 118.24) was similar to that seen at 24 months (48.82 ± 77.14) (p=0.31).

Conclusions : Preliminary analysis of our data shows that in patients with uveitis who received adalimumab, a significant improvement in both central retinal thickness and subfoveal choroidal thickness was seen over time. This improvement was noticeable within 6 months of starting the drug and persisted at 24 months and corresponded well with drug efficacy. We propose that this simple analysis provides us information to help us monitor response to therapy.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.