Programm                 "Degeneration und Regeneration– Grundlagen, Diagnostik und Therapie"

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Selective Anti-TNF-alpha Therapy of Chronic Therapy in Resistent Anterior Segment Inflammation

El-Shabrawi Y., Hermann J.
Dep. of Ophthalmology, Karl-Franzen-University Graz/A

Purpose: Intraocular inflammatory diseases are a leading cause of visual impairment and blindness. Of those patients that develop recurrent or chronic anterior uveitis 23% will have a drop of vision below 20/50. The percentage of legally blind patients is 11%. Thus the treatment of these patients with chronic or recurrent uveitis still presents a quite a challenge, and additional treatment modalities are needed. Thus we tested the efficacy of selective anti-TNFa therapy in chronic inflammatory diseases of the anterior segment of the eye, non-responsive to or not tolerating standard antiinflammatory treatment consisting of a combined immunomodulatory and corticosteroid therapy.
Method: Nine patients suffering from a uveitis associated with a systemic disease were included in this study. Eight patients were suffering from a rheumatic disease, of these five from a spondylarthropathy, two of JIA (one Still’s disease, one ANA positive oligoarthritis patient) and one patient had a necrotizing sclerouveitis in association with Wegener granulomatosis. One additional patient with a uveitis associated with tubulointerstitial nephritis (TINU syndrome) was also included. DMARD therapy was initiated at least 3 months prior to infliximab therapy. It consisted of methotrexate (MTX) in 7 patients, of which two received a combination of MTX and mycofenolate-mofetil. One patient received cylophosphamide, another p

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