The Evaluation Retinal Toxicity of Intravitreal Infliximab Injection

Abstract

Objective To evaluate toxicity of varying doses of Infliximab injecting intravitreally in rabbits. Infliximab, an FDA approved anti-inflammatory drug for Rheumatoid arthritis and Crohn’s disease. It has been reported as an alternative or adjunct drug to chronic recurrent uveitis especially Behcet’s disease, Diabetic retinopathy and PVR Materials and Methods Twenty New Zeland albino rabbits were used for this study and divided into five groups (n=4 each). ARVO guidelines were followed in treatment of animals. The rabbits were injected intravitreally with, 0.125mg 0.250mg, 0.500mg, 1.25mg or 2.5mg Infliximab in 0.1 ml in one eye and 0.1 ml saline solution was used in the contralateral eye. All the animals were examined using indirect ophthalmoscopy and slit-lamp biomicroscopic examination before intravitreal injection and at days 1,7 and 14. An ERG was performed before any treatment and at day 14. On day 14 the animals were euthanized. Histological preparations of the enucleated eyes were examined for retinal toxicity. Results We found no retinal toxicity up to 1.25mg groups according to ERG results and Histological signs. 1of 4 eyes in the 2.5mg group had some significant decrease in Electroretinogram and histological toxicity signs. Conclusions Infliximab injection up to 1.25 mg is nontoxic to the rabbit’s retina. Intravitreal injected Infliximab may be a useful treatment for Uveitis especially Behcet’s disease, Diabetic retinopathy, Age Related Macular Degeneration and Proliferative Vitreoretinopathy.