The efficacy of corticosteroid‐sparing immunomodulatory therapy in treating patients with central multifocal choroiditis

Abstract

Purpose To evaluate the efficacy of corticosteroid‐sparing immunomodulatory therapy (IMT) in patients with recurrent and/or sight‐threatening central multifocal choroiditis (MFC). Methods This was a retrospective cohort study in a tertiary uveitis centre including all patients with MFC who have been treated with IMT for at least 12 months. Clinical data and imaging results were collected regarding the period prior to the start of IMT and at 3, 6, 12 and – where available – 24 months after the start of IMT. Main outcome measure was the number of annual recurrences of choroiditis with or without active choroidal neovascularization before and after the start of IMT. Secondary outcomes were the percentage of patients with (steroid‐free) remission and the median time between the start of IMT and (steroid‐free) remission. Results Thirty‐two patients (39 eyes) were included. At the start of IMT, none of the patients were in (steroid‐free) remission. At 24 months, the probability of achieving remission and steroid‐free remission was 88,5% and 50%, respectively. The median time to achieve remission and steroid‐free remission was 21 and 83 weeks, respectively. In 17 patients (20 eyes) with available clinical data and imaging results for ≥ 12 months prior to the start of IMT, the mean number of recurrences/year decreased significantly from 1.40 ± 0.81 at baseline to 0.49 ± 0.47 (p = 0.001) after the start of IMT. Conclusions Preventive therapy with IMT should be considered in patients with recurrent and/or sight‐threatening MFC to decrease the number of recurrences/year and to increase the prospects of achieving either remission or steroid‐free remission.

Adalimumab Monotherapy in the Treatment of Idiopathic Multifocal Choroiditis: A Case Report

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Idiopathic multifocal choroiditis (MFC): aggressive and prolonged therapy with multiple immunosuppressive agents is needed to halt the progression of active disease. An offbeat review and a case series

“…A recent well conducted study including 32 patients confirmed that immunosuppressive therapy significantly decreased not only the number of recurrences of MFC but also the number of anti-VEGF injections in the cases with CNVs [ 62 ]. Monitoring of therapy is best done by ICGA which is equally or more sensitive than visual field testing to detect actively involved areas and response to therapy showing regression of hypofluorescent areas.…”

Diagnosis and Treatment of Primary Inflammatory Choriocapillaropathies (PICCPs): A Comprehensive Overview

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