INFLIXIMAB and ADALIMUMAB in uveitic macular edema

Abstract

PurposeTo compare the efficacy of infliximab versus adalimumab for the treatment of uveitis related refractory macular edema (ME).MethodsWe included in this retrospective case series patients diagnosed with uveitis related refractory ME and treated with infliximab (IFX) or adalimumab (ADA) at Pitie Salpetriere hospital between 2006 and 2016. All patients were assessed including best corrected visual acuity (BCVA), clinical inflammatory parameters, multimodality imaging, fluorescein angiography, ICG and SD‐OCT. Central foveal thickness (CFT) and retinochoroidal architecture were analysed with SD‐OCT at baseline, 6 and 24 months after treatment initiation. Findings of patients treated with IFX were compared with those of patients treated with ADA. Success was defined as a decrease of more than 50 microns of CMT.ResultsTwelve patients with a mean age of 40 years and 13 patients with a mean age of 46 years were respectively treated with ADA and IFX. At baseline, the mean BCVA of ADA patients was 0.59 logMar ((0; 1,3); median=0,54; SD=0,41) and the mean BCVA of IFX patients was 1,01 logMar ((0,52; 1,3) mediane=1; SD=0,31). The mean CFT of ADA patients was 417μ ((247; 732); median=350; SD=171) and the mean CFT of IFX patients was 450.4μ ((202; 617); median=521; SD=145). Six of the 12 patients (50%) were sucessfully treated by ADA at 6 months, and 8 of the 13 patients (61%) treated by IFX were successful at 6 months. At 6 months, CFT median decreasing from baseline was 61 microns for ADA groupe [range: 17; 136] showing no significant difference vs 92 microns for IFX [9; 165] showing no significant difference (p=0,32).ConclusionsAnti TNF alpha therapy seems to be an efficient treatment at 6 month for uveitis related refractory macular edema. No difference in efficacy was observed between IFX and ADA.