AIMS: Experience with anti-tumour necrosis factor alpha medications in ophthalmology has been mainly in the treatment of resistant uveitis and scleritis. There have been a few case reports and one case series detailing the use of infliximab in the treatment of orbital inflammatory disease, but there is still limited experience with these agents in a variety of orbital inflammatory conditions. We describe successful suppression of inflammation with infliximab in the Idiopathic orbital inflammation, thyroid associated orbital inflammation and chronic relapsing inflammatory optic neuropathy. METHODS: This is a retrospective observational case series of five cases of orbital and ocular inflammation. RESULTS: We describe effects of infliximab in the treatment of three cases of orbital inflammation and two cases of chronic relapsing inflammatory optic neuropathy, all of which were unresponsive to alternative immune modulators. The patients received relief of symptoms and signs of inflammation in all five cases. However, this relief was not absolute as symptoms returned around week 5 post-inflammation. CONCLUSION: This report highlights the expanding role of the biological agents in ophthalmology. Although not the answer in treatment, they offer a valuable alternative to steroids in cases of refractory inflammation.
AIMS: Experience with anti-tumour necrosis factor alpha medications in ophthalmology has been mainly in the treatment of resistant uveitis and scleritis. There have been a few case reports and one case series detailing the use of infliximab in the treatment of orbital inflammatory disease, but there is still limited experience with these agents in a variety of orbital inflammatory conditions. We describe successful suppression of inflammation with infliximab in the Idiopathic orbital inflammation, thyroid associated orbital inflammation and chronic relapsing inflammatory optic neuropathy. METHODS: This is a retrospective observational case series of five cases of orbital and ocular inflammation. RESULTS: We describe effects of infliximab in the treatment of three cases of orbital inflammation and two cases of chronic relapsing inflammatory optic neuropathy, all of which were unresponsive to alternative immune modulators. The patients received relief of symptoms and signs of inflammation in all five cases. However, this relief was not absolute as symptoms returned around week 5 post-inflammation. CONCLUSION: This report highlights the expanding role of the biological agents in ophthalmology. Although not the answer in treatment, they offer a valuable alternative to steroids in cases of refractory inflammation.
Authors: Evelyn C O'Neill; Helen V Danesh-Meyer; Paul P Connell; Ian A Trounce; Michael A Coote; David A Mackey; Jonathan G Crowston Journal: Nat Rev Neurol Date: 2010-03-09 Impact factor: 42.937