Successful use of infliximab therapy in sight-threatening corticosteroid-resistant Vogt-Koyanagi-Harada disease.

Abstract

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: Mathieu Zmuda, Kiet Phong Tiev, Juliette Knoeri, Emmanuel Héron
• Journal: Ocular immunology and inflammation (Ocul Immunol Inflamm) Vol. 21 Issue 4 Pg. 310-6 (Aug 2013) ISSN: 1744-5078 [Electronic] England
• PMID: 23617262 (Publication Type: Case Reports, Letter)

Chemical References

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

Topics

• Anti-Inflammatory Agents, Non-Steroidal (therapeutic use)
• Antibodies, Monoclonal (therapeutic use)
• Diagnosis, Differential
• Female
• Fluorescein Angiography
• Follow-Up Studies
• Fundus Oculi
• Humans
• Infliximab
• Middle Aged
• Tomography, Optical Coherence
• Treatment Outcome
• Tumor Necrosis Factor-alpha (antagonists & inhibitors)
• Uveomeningoencephalitic Syndrome (diagnosis, drug therapy, physiopathology)
• Visual Acuity
• Young Adult