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Six-month outcomes of infliximab and tocilizumab therapy in non-infectious retinal vasculitis

Eye volume 37, pages 2197–2203 (2023)Cite this article

Subjects

Abstract

Purpose

To evaluate the efficacy of infliximab (IFX, 5–10 mg/kg) (Group 1) and tocilizumab (TCZ, 4–8 mg/kg) (Group 2) infusions in non-infectious retinal vasculitis (RV) using Angiographic Scoring for the Uveitis Working Group fluorescein angiography (FA) scoring system.

Methods

Records of 14 patients (24 eyes) in Group 1 and 8 patients (11 eyes) in Group 2 were retrospectively evaluated to assess visual acuity (VA), anterior chamber cell and flare, vitreous haze, central subfield thickness (CST), and FA scoring at baseline and 6 months of follow-up. The measurements were employed to grade in each group.

Results

In Group 1 and 2, respectively, there was no underlying disease in 9 (60%) and 3 (42.9%) patients. Three (42.9%) patients in Group 2 had juvenile idiopathic arthritis (JIA) as the most common identified cause. Mean improvement in VA (log MAR) and CST were 0.04 ± 0.14 and 40.3 ± 78.5 µm in Group 1; 0.04 ± 0.09 and 47.3 ± 82.3 µm in Group 2, respectively. Mean FA scores were significantly reduced from 12.4 ± 5.2 and 11.6 ± 4.4 at baseline to 6.4 ± 5.0 and 5.8 ± 3.9 at 6-month in Group 1 and 2, respectively. In Group 2, 9 eyes of 6 patients (75%) had the history of IFX use prior to TCZ initiation. There was no significant safety concern requiring treatment discontinuation during the follow-up in either group.

Conclusion

IFX and TCZ infusions showed statistically significant improvement of non-infectious RV as shown by ASUWOG FA Scoring System. TCZ, as well as IFX, appeared to be effective treatment options for non-infectious RV.

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Fig. 1: Fluorescein angiography images of a representative patient who received infliximab at baseline.
Fig. 2: Fluorescein angiography images of a representative patient who received tocilizumab at baseline.

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Data availability

The datasets generated during and/or analyzed during the current study are only available from the corresponding author on reasonable request.

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Acknowledgements

IK was supported by a grant from the International Council of Ophthalmology (ICO) Retina Research Foundation (RRF) Helmerich Fellowship Program, as the recipient of 2020 ICO-RRF Helmerich One-Year Fellowship Award. WM was supported by a grant from the Japan Eye Bank Association Oversea Research Program and Kobe University Long Term Oversea Visit Program for Young Researchers.

Funding

Research to Prevent Blindness Department Challenge Award and National Eye Institute of the National Institutes of Health P30 Award (EY026877) have been awarded to the Byers Eye Institute at Stanford University.

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Authors and Affiliations

  1. Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, CA, USA

    Irmak Karaca, Gunay Uludag, Wataru Matsumiya, Jonathan Regenold, Christopher Or, Azadeh Mobasserian, Muhammad Sohail Halim, Moosa Zaidi, Sherin Lajevardi, Ami Dongchau, Hashem Ghoraba & Quan Dong Nguyen

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Contributions

IK was responsible for conducting the research, designing the study, extracting and analyzing the data, interpreting the results, writing and revising the manuscript; GU contributed in extracting the data, editing and critical revision of the manuscript; WM was responsible for analyzing the data, interpreting the results, critical revision of the manuscript; JR was responsible for editing and revision of the manuscript; CO contributed in interpreting the data and critical revision of the manuscript; AM contributed in interpreting the data; MSH contributed to design of the study and data interpretation; MZ contributed in analyzing and interpreting the data; SL was responsible for extracting the data; AD was responsible for extracting the data; HG contributed in analyzing and interpreting the data, editing and critical revision of the manuscript; QDN was responsible for critical revision of the manuscript.

Corresponding author

Correspondence to Quan Dong Nguyen.

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QDN serves on the Scientific Advisory Board for Affibody, Acelyrin, and Regeneron. The remaining authors declare that there are no conflicts of interest related to this manuscript.

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Karaca, I., Uludag, G., Matsumiya, W. et al. Six-month outcomes of infliximab and tocilizumab therapy in non-infectious retinal vasculitis. Eye 37, 2197–2203 (2023). https://doi.org/10.1038/s41433-022-02315-9

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