Journal
GRAEFES ARCHIVE FOR CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY
Volume 260, Issue 6, Pages 2013-2021Publisher
SPRINGER
DOI: 10.1007/s00417-021-05539-9
Keywords
Punctate inner choroidopathy; Multifocal choroiditis; Choroidal neovascular membrane; Adalimumab; Steroid-sparing
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Adalimumab therapy for refractory PIC/MFC enables steroid-sparing effect, decreases disease flares, and preserves vision over a mean follow-up of 17.8 months.
Purpose This study aims to evaluate the outcomes of adalimumab (ADA) therapy in patients with refractory punctate inner choroidopathy (PIC) and multifocal choroiditis (MFC). Methods Demographic and clinical data, including LogMAR best-corrected visual acuity (BCVA), were retrospectively collected. Doses of prednisone, immunomodulatory therapies (IMT), and anti-vascular endothelial growth factor (VEGF) injections before and after baseline (ADA initiation) were recorded, as well as the time to clinical remission, time to first flare, and drug-associated adverse events. Results Seven patients (4 females, ten eyes) were included. The mean follow-up after baseline was 17.8 +/- 11.1 months (range 6-33). The mean LogMAR BCVA was 0.35 +/- 0.77 at 6 months before baseline and remained stable throughout 12 months after baseline (0.31 +/- 0.46 at 12 months; p = 0.47). The mean dose of prednisone decreased from 17.3 +/- 19.6 mg/day 6 months before baseline (range 0-60) to 2.6 +/- 2.4 mg/day at the last follow-up (range 0-6, p = 0.03). The mean number of flares decreased significantly from 1.43 +/- 0.79 over a 6-month period before baseline to 0.2 +/- 0.45 (p = 0.02) at 6-12 months after baseline. The mean number of anti-VEGF injections was 4.17 +/- 3.92 over the 12-month period before baseline, and it was 2.17 +/- 3.06 (p = 0.31) during the first 12 months after baseline. No adalimumab-related adverse events were noted. Conclusion Adalimumab therapy for refractory PIC/MFC enabled a significant steroid-sparing effect, decreased disease flares, and preserved vision over a mean follow-up of 17.8 months.
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