Infliximab therapy for idiopathic retinal vasculitis, aneurysm, and neuroretinitis syndrome.

Abstract

PURPOSE:

We report our experience in treating 2 patients of idiopathic retinal vasculitis, aneurysm, and neuroretinitis (IRVAN) syndrome with antitumor necrosis factor agent, infliximab, who showed a very favorable response to treatment.

METHODS:

Two patients with clinical diagnosis of IRVAN syndrome were included in the study. The visual acuity was affected due to ocular inflammation and presence of macular edema due to exudation around the optic nerve.

RESULTS:

The patients did not respond to initial treatment with oral steroids, and visual acuity continued to deteriorate due to macular exudation. Infliximab therapy resulted in prompt resolution of the inflammatory reaction and retinal exudation, with improvement in visual acuity, that was subsequently maintained with maintenance therapy. The intravenous infliximab infusions were scheduled at 0, 4, 8, and 12 weeks initially, and every 2 months thereafter. Retinal neovasculariztion in each patient was managed by pan retinal photocoagulation.

CONCLUSION:

Infliximab therapy may be useful in reducing inflammation and leakage from the optic nerve in patients with IRVAN syndrome. This may help preserve or improve visual acuity. However, further studies are required to evaluate the long-term benefits of this therapy.

• Authors: Rizwan A Cheema, Essam Al-Askar, Haider R Cheema
• Journal: Journal of ocular pharmacology and therapeutics : the official journal of the Association for Ocular Pharmacology and Therapeutics (J Ocul Pharmacol Ther) Vol. 27 Issue 4 Pg. 407-10 (Aug 2011) ISSN: 1557-7732 [Electronic] United States
• PMID: 21563921 (Publication Type: Case Reports, Journal Article)

Chemical References

• Anti-Inflammatory Agents
• Antibodies, Monoclonal
• Tumor Necrosis Factor-alpha
• Infliximab

Topics

• Adult
• Aneurysm (complications, drug therapy, physiopathology)
• Anti-Inflammatory Agents (therapeutic use)
• Antibodies, Monoclonal (therapeutic use)
• Female
• Humans
• Infliximab
• Infusions, Intravenous
• Laser Coagulation (methods)
• Macular Edema (drug therapy, etiology)
• Male
• Optic Nerve (pathology)
• Retinal Vasculitis (complications, drug therapy, physiopathology)
• Retinitis (complications, drug therapy, physiopathology)
• Syndrome
• Tumor Necrosis Factor-alpha (antagonists & inhibitors)
• Visual Acuity (drug effects)