Intravitreal Infliximab in Patients With Macular Degeneration Who Are Nonresponders to Antivascular Endothelial Growth Factor Therapy

Arias, Luis; Caminal, Josep M.; Badía, M.; Rubio, Marc; Català, Jaume; Pujol, O.

doi:10.1097/iae.0b013e3181e9f942

Cited by 46 publications

(37 citation statements)

References 20 publications

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“…In this series of cases, reaction was observed in the anterior chamber and vitritis in 50% (23) . In this study, three patients had anterior chamber reaction (1+) with flare and cells in the first postoperative day.…”

Section: Discussionmentioning

confidence: 91%

“…In none of the animal studies and case series in humans the pro gression of cataract was demonstrated (13,23) . As in studies with BCVA= best-corrected visual acuity; IOP= intraocular pressure; HM= hand motion; CF 1'= count finger at one foot; CF 3'= count finger at three feet; CF 4'= count finger at four feet; CF 7'= count finger at seven feet.…”

Section: Discussionmentioning

confidence: 99%

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Intravitreal bevacizumab combined with infliximab in the treatment of choroidal neovascularization secondary to age-related macular degeneration: case report series

Freitas¹,

Isaac²,

Tannure³

et al. 2013

Arq. Bras. Oftalmol.

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Intravitreal bevacizumab combined with infliximab in the treatment of choroidal neovascularization secondary to age-related macular degeneration: case report series ABSTRACTPurpose: To evaluate the feasibility of the combined use of bevacizumab (Avastin ® ) and combined with infliximab (Remicade ® ) in the treatment of naive choroidal neovascularization due to age-related macular degeneration eyes. Methods: Intravitreal injections of bevacizumab combined with infliximab in 6 neovascular age-related macular degeneration eyes. All patients underwent complete ophthalmologic examination on the initial visit and at days 1, 30, 60, 90, 120, 150 and 180 following the first injection. Optical coherence tomography and fluorescein angiography were performed during at initial visit and monthly during the 6 months follow-up period. Electroretinography was performed before and 30 days after initial injection, in order to evaluate retinal toxicity induced by such treatment. Results: Thirty days after the first injection, 5 eyes (83%) shown decrease in macular thickness. No change was seen in electroretinogram in any eyes compared to initially performed electroretinogram. All phakic eyes developed cataract. One patient developed vitritis and was submitted to medical treatment successfully. At the end of the 6 months follow-up period, 4 patients showed significant improvement in the exudative process of choroidal neovascularization. One eye had mild persistent submacular fluid without active choroidal neovascularization, and another eye had persistent amount of intraretinal fluid due to active choroidal neovascularization. Conclusion:The combined use of bevacizumab with infliximab in eyes with neovascular age-related macular degeneration was effective in reducing leakage and improving the macular thickness. However, it is not possible to assert that the results were related to synergic effects of the combination therapy. A controlled study with more cases is necessary to precisely define the complica tion rates; however the dosage and/or association of drugs studied in this research should not be recommended in clinical practice due to cataract as well as inflam matory reaction. Keywords

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Intravitreal bevacizumab combined with infliximab in the treatment of choroidal neovascularization secondary to age-related macular degeneration: case report series

Freitas¹,

Isaac²,

Tannure³

et al. 2013

Arq. Bras. Oftalmol.

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“…Redfree photograph showing cystoid changes of the right eye. b Late phase of the FA showing fluorescein leakage in a petalloid pattern with some hyperfluorescence of the optic nerve 0.5 or 2 mg might be immunogenic and retinotoxic [22,25]. In addition, in another study almost 40 % of patients with refractory diabetic macular edema that were injected with 2 mg of intravitreal infliximab exhibited a high degree of severe intraocular inflammation [26].…”

Section: Discussionmentioning

confidence: 96%

Intravitreal infliximab for refractory pseudophakic cystoid macular edema: results of the Pan-American Collaborative Retina Study Group

Arévalo²,

Hernández-Bogantes

et al. 2012

Int Ophthalmol

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Inflammation is the major etiologic factor in the development of pseudophakic cystoid macular edema (CME). Several soluble mediators of inflammation such as tumor necrosis factor alpha (TNF-α) have been implicated in the pathogenesis of ocular inflammation. The purpose of this study is to report the short-term visual and anatomic outcomes following intravitreal injections of infliximab in eyes with refractory CME secondary to cataract surgery. An interventional, retrospective study of 7 eyes with refractory CME that were injected with 1 mg of infliximab. The main outcome measures were best-corrected visual acuity (BCVA) and central macular thickness (CMT) at 6-month follow-up. At the 6 month follow-up, BCVA improved from 1.14 ± 0.59 logMAR at baseline to 0.51 ± 0.35 logMAR (p = 0.0156). CMT also improved from 584 ± 159 μm at baseline to 327 ± 127 μm at 6 months (p = 0.0111). No systemic adverse events were reported in these patients. There was a single episode of uveitis that responded to topical steroids. Inhibition of TNF-α may be beneficial in the treatment of refractory pseudophakic CME.

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“…27,28 Intravitreal infliximab in humans has been limited to a handful of reports. 12,13,29 Theodossiadis et al 12 injected 3 patients with AMD unresponsive to ranibizumab with 2 injections of 2 mg of infliximab given 2 months apart. They reported improvement and no safety concerns.…”

Section: Discussionmentioning

confidence: 98%

“…In contrast, Giganti et al 13 reported that intravitreal infliximab at a dose of 0.5 mg was not only not effective in 2 eyes with exudative AMD and 2 eyes with diabetic macular edema but also immunogenic and probably retinotoxic. Arias et al 29 conducted a prospective interventional trial of 4 eyes with exudative AMD refractory to anti-VEGF agents. They found that intravitreal infliximab at a dose of 2 mg did not provide any visual or anatomic benefit.…”

Section: Discussionmentioning

confidence: 99%

Intravitreal Tumor Necrosis Factor-Alpha Inhibitors for Neovascular Age-Related Macular Degeneration Suboptimally Responsive to Antivascular Endothelial Growth Factor Agents: A Pilot Study from the Pan American Collaborative Retina Study Group

Arévalo

Hernández-Bogantes

et al. 2013

Journal of Ocular Pharmacology and Therapeutics

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Intravitreal Infliximab in Patients With Macular Degeneration Who Are Nonresponders to Antivascular Endothelial Growth Factor Therapy

Cited by 46 publications

References 20 publications

Intravitreal bevacizumab combined with infliximab in the treatment of choroidal neovascularization secondary to age-related macular degeneration: case report series

Intravitreal bevacizumab combined with infliximab in the treatment of choroidal neovascularization secondary to age-related macular degeneration: case report series

Intravitreal infliximab for refractory pseudophakic cystoid macular edema: results of the Pan-American Collaborative Retina Study Group

Intravitreal Tumor Necrosis Factor-Alpha Inhibitors for Neovascular Age-Related Macular Degeneration Suboptimally Responsive to Antivascular Endothelial Growth Factor Agents: A Pilot Study from the Pan American Collaborative Retina Study Group

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