Abstract
Objective: To assess the efficacy and safety of Tocilizumab (TCZ) for the treatment of cystoid macular edema (CME) associated to non-infectious uveitis in a series of 7 patients at 24 months of follow-up.
Methods: Retrospective case series of 7 patients with CME secondary to noninfectious uveitis who had inadequate response to corticosteroids and at least 1 conventional immunosuppressive drug and in most cases to other biological agent. Macular thickness, intraocular inflammation, best corrected visual acuity (BCVA) and steroid- sparing effect were the main variables analyzed.
Results: 7 patients with a mean age of 38.9 ± 17.8 years with refractory uveitic CME were studied. Underlying diseases associated were: juvenile idiopathic arthritis (n=3), Birdshot (n=2) and idiopathic uveitis (n=2). All patients had bilateral involvement. TCZ was prescribed in combination with conventional immunosuppressive drugs in 5 of 7 patients. After 24 months of therapy, a statistically significant improvement in macular thickness (397.8 ± 232.1 µm vs. 231.3 ± 42.1 µm, P<0.01) and BCVA (0.32 ± 0.23 at baseline vs. 0.59 ± 0.33 at 24-month last visit, P=0.007) was obtained. A glucocorticoid sparing-effect was also observed. Remission was achieved in 6 patients and no severe adverse events were noticed at 2 years follow-up.
Conclusions: TCZ seems to be effective and safe in refractory uveitic CME at 24 months follow-up.
Keywords
Cystoid macular edema, Uveitis, Anti-TNF therapy, Tocilizumab