LONG-TERM OUTCOMES OF RITUXIMAB THERAPY IN PATIENTS WITH NONINFECTIOUS POSTERIOR UVEITIS REFRACTORY TO CONVENTIONAL IMMUNOSUPPRESSIVE THERAPY

Retina. 2018 Feb;38(2):395-402. doi: 10.1097/IAE.0000000000001563.

Abstract

Purpose: To assess long-term effectiveness of rituximab therapy for refractory noninfectious uveitis affecting the posterior segment.

Methods: Retrospective case series. Patients diagnosed with recalcitrant noninfectious posterior uveitis who were treated with rituximab intravenous infusions between 2010 and 2015 were included. Patients underwent best-corrected visual acuity testing and fluorescein angiography evidence of disk or vascular staining at 6, 12, 18, and 24 months. Patients had at least 24 months of follow-up.

Results: Eleven patients (21 eyes) with refractory posterior uveitis treated with intravenous rituximab were included. Nine (81.8%) patients were female. Mean follow-up was 29.3 ± 7.8 months. rituximab was administered as complementary therapy because of previous inefficacy of other therapies in 7 (63.7%) patients, and it was the only treatment in four (36.3%) patients who did not tolerate other drugs. Inflammation signs by fluorescein angiography were controlled in nine (81.8%) patients at the end of follow-up. Baseline best-corrected visual acuity was 20/80 (logarithm of the minimal angle of resolution 0.6 ± 0.4), and final best-corrected visual acuity was 20/40 (0.3 ± 0.5) (P = 0.005). No significant side effects were reported.

Conclusion: Rituximab therapy was associated with stability and remission of recalcitrant noninfectious posterior uveitis in patients who did not tolerate or did not respond to other therapies.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antirheumatic Agents / administration & dosage
  • Drug Resistance / drug effects*
  • Female
  • Fluorescein Angiography
  • Follow-Up Studies
  • Fundus Oculi
  • Humans
  • Immunosuppression Therapy / methods*
  • Immunosuppressive Agents / pharmacology*
  • Injections, Intravenous
  • Male
  • Middle Aged
  • Optic Disk / pathology*
  • Retrospective Studies
  • Rituximab / administration & dosage*
  • Time Factors
  • Tomography, Optical Coherence
  • Treatment Outcome
  • Uveitis, Posterior / diagnosis
  • Uveitis, Posterior / drug therapy*
  • Visual Acuity*
  • Young Adult

Substances

  • Antirheumatic Agents
  • Immunosuppressive Agents
  • Rituximab