Samaneh Davoudi1, Nazanin Ebrahimiadib2, Cagla Yasa1, Damla D Sevgi1, Ramak Roohipoor2, Evangelia Papavasilieou1, Jason Comander1, Lucia Sobrin3. 1. Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts. 2. Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts; Department of Ophthalmology, Farabi Eye Hospital, Eye Research Center, Tehran University of Medical Sciences, Tehran, Iran. 3. Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts. Electronic address: Lucia_sobrin@meei.harvard.edu.
Abstract
PURPOSE: To evaluate clinical and ancillary testing, including adaptive optics, outcomes in autoimmune retinopathy (AIR) patients treated with rituximab. DESIGN: Retrospective, interventional case series. METHODS: patients: Sixteen AIR patients treated with rituximab. OBSERVATION PROCEDURES: All patients were treated with a loading and maintenance dose schedule of intravenous rituximab. Visual acuity (VA), electroretinography (ERG), and spectral-domain optical coherence tomography (SDOCT) and visual field (VF) results were recorded. A subset of patients was also imaged using adaptive optics scanning laser ophthalmoscopy (AO-SLO). MAIN OUTCOME MEASURES: Rates of VA change before vs after rituximab initiation were compared with mixed-model linear regression. RESULTS: The rate of visual decline was significantly less after rituximab initiation compared with the rate of visual decline prior to rituximab initiation (P = .005). Seventy-seven percent of eyes had stable or improved VA 6 months after rituximab initiation. Amplitudes and implicit times on ERG, mean deviation on VF, central subfield mean thickness, and total macular volume did not decrease to a significant degree over the rituximab treatment period. Six eyes had serial AO-SLO imaging. Cone densities did not change significantly over the treatment period. CONCLUSION: VA was stable or improved in a majority of AIR patients while they were being treated with rituximab. OCT and ERG parameters, as well as AO-SLO cone densities, were stable during treatment. Studies with additional patients and longer follow-up periods are needed to further explore the utility of rituximab in the management of AIR.
PURPOSE: To evaluate clinical and ancillary testing, including adaptive optics, outcomes in autoimmune retinopathy (AIR) patients treated with rituximab. DESIGN: Retrospective, interventional case series. METHODS:patients: Sixteen AIR patients treated with rituximab. OBSERVATION PROCEDURES: All patients were treated with a loading and maintenance dose schedule of intravenous rituximab. Visual acuity (VA), electroretinography (ERG), and spectral-domain optical coherence tomography (SDOCT) and visual field (VF) results were recorded. A subset of patients was also imaged using adaptive optics scanning laser ophthalmoscopy (AO-SLO). MAIN OUTCOME MEASURES: Rates of VA change before vs after rituximab initiation were compared with mixed-model linear regression. RESULTS: The rate of visual decline was significantly less after rituximab initiation compared with the rate of visual decline prior to rituximab initiation (P = .005). Seventy-seven percent of eyes had stable or improved VA 6 months after rituximab initiation. Amplitudes and implicit times on ERG, mean deviation on VF, central subfield mean thickness, and total macular volume did not decrease to a significant degree over the rituximab treatment period. Six eyes had serial AO-SLO imaging. Cone densities did not change significantly over the treatment period. CONCLUSION: VA was stable or improved in a majority of AIR patients while they were being treated with rituximab. OCT and ERG parameters, as well as AO-SLO cone densities, were stable during treatment. Studies with additional patients and longer follow-up periods are needed to further explore the utility of rituximab in the management of AIR.
Authors: Fred K Chen; Xiao Zhang; Jonathan Eintracht; Dan Zhang; Sukanya Arunachalam; Jennifer A Thompson; Enid Chelva; Dominic Mallon; Shang-Chih Chen; Terri McLaren; Tina Lamey; John De Roach; Samuel McLenachan Journal: Doc Ophthalmol Date: 2018-11-16 Impact factor: 2.379
Authors: Júlia T Takiuti; Vitor K L Takahashi; Christine L Xu; Ruben Jauregui; Stephen H Tsang Journal: Ophthalmic Genet Date: 2019-08-08 Impact factor: 1.803
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Authors: Lynn K Stanwyck; Weilin Chan; Arjun Sood; Gayatri Susarla; John Romano; Maria Pefkianaki; Kanishka Thiran Jayasundera; John R Heckenlively; Steven K Lundy; Lucia Sobrin Journal: Transl Vis Sci Technol Date: 2020-06-16 Impact factor: 3.283