PURPOSE: To report an experience with infliximab in severe corticosteroid-resistant Vogt-Koyanagi-Harada (VKH) disease. DESIGN: Interventional case series. METHODS: The medical records of 2 adult patients were reviewed. RESULTS: Both patients had a visual acuity reduced to hand motion perception bilaterally after 1 month of high-dose corticosteroid therapy, due to multiple exudative retinal detachment involving the fovea. Visual acuity and OCT findings improved immediately after the first infliximab infusion, retinal detachments fully resolved after 1 month and visual acuity returned to normal within 6 months. Despite a negative pretreatment screening, one patient developed multivisceral tuberculosis, which led to infliximab discontinuation after the 7th infusion and was cured by a 9-month ambulatory antibiotic regimen. The other patient received 11 well-tolerated infliximab infusions. Respectively, 9 and 4 months after infliximab discontinuation both patients had normal vision and OCT findings. CONCLUSION: Infliximab showed tremendous therapeutic efficacy in sight-threatening corticosteroid-resistant VKH disease.
PURPOSE: To report an experience with infliximab in severe corticosteroid-resistant Vogt-Koyanagi-Harada (VKH) disease. DESIGN: Interventional case series. METHODS: The medical records of 2 adult patients were reviewed. RESULTS: Both patients had a visual acuity reduced to hand motion perception bilaterally after 1 month of high-dose corticosteroid therapy, due to multiple exudative retinal detachment involving the fovea. Visual acuity and OCT findings improved immediately after the first infliximab infusion, retinal detachments fully resolved after 1 month and visual acuity returned to normal within 6 months. Despite a negative pretreatment screening, one patient developed multivisceral tuberculosis, which led to infliximab discontinuation after the 7th infusion and was cured by a 9-month ambulatory antibiotic regimen. The other patient received 11 well-tolerated infliximab infusions. Respectively, 9 and 4 months after infliximab discontinuation both patients had normal vision and OCT findings. CONCLUSION:Infliximab showed tremendous therapeutic efficacy in sight-threatening corticosteroid-resistant VKH disease.
Authors: Elizabeth Shen; Sivakumar R Rathinam; Manohar Babu; Anuradha Kanakath; Radhika Thundikandy; Salena M Lee; Erica N Browne; Travis C Porco; Nisha R Acharya Journal: Am J Ophthalmol Date: 2016-06-10 Impact factor: 5.258