Rituximab in the Treatment of Refractory Noninfectious Scleritis

Abstract

To describe the outcomes of the use of rituximab in the treatment of refractory noninfectious scleritis. Retrospective case series. Review of the medical charts of patients with noninfectious scleritis refractory to conventional immunomodulatory therapy who were seen at the Massachusetts Eye Research and Surgery Institution between 2005 and 2015. The primary outcome measure in this study was steroid-free remission. Secondary outcomes were favorable response (decrease in scleritis activity score) and decrease in steroid dependence. There were 15 patients, with a mean follow-up duration of 34months. Fourteen patients (93.3%) showed a clinical improvement, with 13 (86.6%) achieving a scleritis activity score of zero at 6months. To date, 2 patients continue to enjoy durable drug-free remission (28 and 32months follow-up). There was only 1 adverse effect recorded (infusion hypotension) requiring cessation of rituximab. Rituximab can be an effective treatment modality for recalcitrant noninfectious scleritis and, in some, can result in long-term durable drug-free remission.