Abstract
Purpose
Paediatric uveitis is a potentially blinding disease. With increased treatment options in the era of biologics, there is little evidence for tocilizumab (TCZ), anti‐IL‐6 receptor, as a treatment option in refractory paediatric non‐anterior uveitis. Our aim is to describe the successful results of TCZ treatment in children with refractory non‐anterior uveitis.
Methods
This is a retrospective case series study in two tertiary university referral centers. Six children with refractory non‐anterior uveitis were treated with TCZ with a minimum follow‐up of 6 months. All patients failed on anti‐TNF therapy. TCZ was given intravenously every 4 weeks at 8 mg/kg doses with a second infusion given after two weeks. Results before and after treatment are reported by showing the changes in scores of fluorescence angiogram (FA), vitreous cell grade, central macular and retinal neural fibre layer thickness (CMT) on optical coherence tomography, best corrected visual acuity (BCVA) and dosage of systemic steroids. Complications and side effects are being reported.
Results
There was a striking reduction in overall FA score, from 14.5 (9.5–18.25) to 5 (1.5–10.5) p = 0.027. This was mostly due to reduction in cystoid macular edema (CME) and capillary leakage. The median CMT decreased from 321 μm (317–470.5 μm) at baseline to 308.2 μm (269–353.5) after 6 months of treatment (p = 0.255). There was no difference in BCVA. No systemic or ocular complications were reported during follow‐up.
Conclusion
Intravenous administration of TCZ is a good therapeutic option for reducing disease activity and reduction of CME in children with refractory non‐anterior uveitis.
Paediatric uveitis is a potentially blinding disease. With increased treatment options in the era of biologics, there is little evidence for tocilizumab (TCZ), anti‐IL‐6 receptor, as a treatment option in refractory paediatric non‐anterior uveitis. Our aim is to describe the successful results of TCZ treatment in children with refractory non‐anterior uveitis.
Methods
This is a retrospective case series study in two tertiary university referral centers. Six children with refractory non‐anterior uveitis were treated with TCZ with a minimum follow‐up of 6 months. All patients failed on anti‐TNF therapy. TCZ was given intravenously every 4 weeks at 8 mg/kg doses with a second infusion given after two weeks. Results before and after treatment are reported by showing the changes in scores of fluorescence angiogram (FA), vitreous cell grade, central macular and retinal neural fibre layer thickness (CMT) on optical coherence tomography, best corrected visual acuity (BCVA) and dosage of systemic steroids. Complications and side effects are being reported.
Results
There was a striking reduction in overall FA score, from 14.5 (9.5–18.25) to 5 (1.5–10.5) p = 0.027. This was mostly due to reduction in cystoid macular edema (CME) and capillary leakage. The median CMT decreased from 321 μm (317–470.5 μm) at baseline to 308.2 μm (269–353.5) after 6 months of treatment (p = 0.255). There was no difference in BCVA. No systemic or ocular complications were reported during follow‐up.
Conclusion
Intravenous administration of TCZ is a good therapeutic option for reducing disease activity and reduction of CME in children with refractory non‐anterior uveitis.
| Original language | English |
|---|---|
| Pages (from-to) | 16-16 |
| Journal | Acta Ophthalmologica |
| Volume | 97 |
| Issue number | S262 |
| Publication status | Published - Mar 2019 |