Long-term effects of tocilizumab on retinal and choroidal inflammation in refractory non-infectious uveitis
Purpose
Tocilizumab (TCZ), an interleukin-6 receptor antagonist, is approved for treating rheumatic diseases and has been shown to be effective in managing refractory non-infectious uveitis by reducing central retinal thickness (CRT). This retrospective study aimed to investigate the long-term effects of TCZ on inflammation in the retinal and choroidal compartments.
Methods
Twenty eyes with refractory non-infectious uveitis from 10 patients who received TCZ were included in the analysis. The primary outcomes measured were inflammatory activity in the retina and choroid, which were assessed by fluorescein angiography (FA) and indocyanine green angiography (ICGA) using the Angiography Scoring for Uveitis Working Group at baseline and at 6, 12, 24, 36 months.
Results
Birdshot Retinochoroiditis (n=8) was the most common uveitis, followed by idiopathic intermedia (n=1) and posterior (n=1) uveitis. The mean follow-up time was 25.8 months. At baseline, the mean FA score was 12.5 +/-3.9, which significantly decreased over time (36 months: 7.9 +/-4.0; p = .004). In contrast, the ICGA score significantly increased within the first year (baseline: 5.9 +/-2.4; 6 months: 6.9 +/-2.6; 12 months: 7.3 +/-2.7; p = .002) but returned to baseline levels after 2 years (24 months: 5.3 +/-1.9; 36 months: 5.4 +/-2.5). CRT improved significantly after 6 months (baseline: 341.5µm +/-140.9; 6 months: 283.9µm +/-39.6; p = .001).
Conclusion
TCZ is effective in reducing retinal vasculitis in refractory non-infectious uveitis over time, but not as effective in managing choroiditis. Further studies are needed to determine the optimal duration of TCZ therapy for uveitis.
Conflict of interest
No
Authors 1
Last name
ZUR BONSEN
Initials of first name(s)
LS
Department
Department of Ophthalmology, Charité – Universitätsmedizin Berlin
City
Berlin
Country
Germany
Authors 2
Last name
Schulze
Initials of first name(s)
D
Department
Institute of Biometry and Clinical Epidemiology, Charité – Universitätsmedizin Berlin
City
Berlin
Country
Germany
Authors 3
Last name
Künzel
Initials of first name(s)
S
Department
Department of Ophthalmology, Charité – Universitätsmedizin Berlin
City
Berlin
Country
Germany
Authors 4
Last name
Rübsam
Initials of first name(s)
A
Department
Department of Ophthalmology, Charité – Universitätsmedizin Berlin
City
Berlin
Country
Germany
Authors 5
Last name
Pleyer
Initials of first name(s)
U
Department
Department of Ophthalmology, Charité – Universitätsmedizin Berlin
City
Berlin
Country
Germany
Authors 6
Last name
Pohlmann
Initials of first name(s)
D
Department
Department of Ophthalmology, Charité – Universitätsmedizin Berlin
City
Berlin
Country
Germany
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