To assess the efficacy of the anti- TNF monoclonal antibody infliximab in uveitis patients without clinically evident ocular inflammation and impaired visual acuity because of chronic cystoid macular edema (CME). Pros...To assess the efficacy of the anti- TNF monoclonal antibody infliximab in uveitis patients without clinically evident ocular inflammation and impaired visual acuity because of chronic cystoid macular edema (CME). Prospective, noncomparative, interventional case series. Patients with refractory CME (14 eyes, mean duration of 14 months), associated with intermediate uveitis (n=6), Adamantiades- Behcet disease (n=2), adult- type vascular pseudotumor (n=1), and HLAB27+ - related uveitis (n =1) received an intravenous infliximab infusion (5 mg/kg); five patients were retreated after 1 month. Macular thickness, measured by ocular coherence tomography, was reduced from 428 ± 138 μ m to 219 ± 51 μ m at 2 months postbaseline (P=. 000 1), while visual acuity increased from 0.41 ± 0.18 to 0.83 ± .0.17 (P < .000 01). Anatomic and functional improvement was sustained at 6 months in all. No ocular or extra- ocular side effects were noted. These promising results suggest that TNF may play an important pathogenetic role in chronic CME, thus, a controlled trial is warranted.rights reserved.展开更多
To assess the role of cardiovascular morbidity, its risk factors, and microalb uminuria in the development of inflammatory cystoid macular edema (CME). A match ed case-control study. study population: We included 24 c...To assess the role of cardiovascular morbidity, its risk factors, and microalb uminuria in the development of inflammatory cystoid macular edema (CME). A match ed case-control study. study population: We included 24 consecutive patients wi th uveitis and CME. Twenty four uveitis patients without CME, matched for age an d duration of uveitis served as controls. intervention and observation procedure s: Patients and controls were interviewed for the presence of cardiovascular ris k factors and cardiovascular morbidity. All medications were registered. Morning urinary albumin concentration was measured, as well as blood pressure, C-react ive protein, and creatinine in blood. Patients suffering from diabetes mellitus were excluded from this study. main outcome measures: The presence of cardiovasc ular morbidity and its risk factors and microalbuminuria in uveitis patients wit h and without CME. We found a positive association between trace-and/or microal buminuria and inflammatory CME (P=. 001; odds ratio 13.0, 95%CI 2.5 to 68.1 and P=. 015; odds ratio 5.9, 95%CI 1.6 to 22.6), but no relation between CME and c ardiovascular morbidity or its risk factors. No additional association between t race-and/or any microalbuminuria and general characteristics of patients, speci fic factors related to general disease as a cause of ocular inflammation, locati on of uveitis, duration of uveitis, and medication was found. The presence of tr ace-and/or microalbuminuria in inflammatory CME might indicate the presence of early systemic vascular disease and carry the risk of developing CME. This findi ng brings new insight into the pathogenesis of CME and could open up new avenues for the treatment of CME.展开更多
文摘To assess the efficacy of the anti- TNF monoclonal antibody infliximab in uveitis patients without clinically evident ocular inflammation and impaired visual acuity because of chronic cystoid macular edema (CME). Prospective, noncomparative, interventional case series. Patients with refractory CME (14 eyes, mean duration of 14 months), associated with intermediate uveitis (n=6), Adamantiades- Behcet disease (n=2), adult- type vascular pseudotumor (n=1), and HLAB27+ - related uveitis (n =1) received an intravenous infliximab infusion (5 mg/kg); five patients were retreated after 1 month. Macular thickness, measured by ocular coherence tomography, was reduced from 428 ± 138 μ m to 219 ± 51 μ m at 2 months postbaseline (P=. 000 1), while visual acuity increased from 0.41 ± 0.18 to 0.83 ± .0.17 (P < .000 01). Anatomic and functional improvement was sustained at 6 months in all. No ocular or extra- ocular side effects were noted. These promising results suggest that TNF may play an important pathogenetic role in chronic CME, thus, a controlled trial is warranted.rights reserved.
文摘To assess the role of cardiovascular morbidity, its risk factors, and microalb uminuria in the development of inflammatory cystoid macular edema (CME). A match ed case-control study. study population: We included 24 consecutive patients wi th uveitis and CME. Twenty four uveitis patients without CME, matched for age an d duration of uveitis served as controls. intervention and observation procedure s: Patients and controls were interviewed for the presence of cardiovascular ris k factors and cardiovascular morbidity. All medications were registered. Morning urinary albumin concentration was measured, as well as blood pressure, C-react ive protein, and creatinine in blood. Patients suffering from diabetes mellitus were excluded from this study. main outcome measures: The presence of cardiovasc ular morbidity and its risk factors and microalbuminuria in uveitis patients wit h and without CME. We found a positive association between trace-and/or microal buminuria and inflammatory CME (P=. 001; odds ratio 13.0, 95%CI 2.5 to 68.1 and P=. 015; odds ratio 5.9, 95%CI 1.6 to 22.6), but no relation between CME and c ardiovascular morbidity or its risk factors. No additional association between t race-and/or any microalbuminuria and general characteristics of patients, speci fic factors related to general disease as a cause of ocular inflammation, locati on of uveitis, duration of uveitis, and medication was found. The presence of tr ace-and/or microalbuminuria in inflammatory CME might indicate the presence of early systemic vascular disease and carry the risk of developing CME. This findi ng brings new insight into the pathogenesis of CME and could open up new avenues for the treatment of CME.
