Background: Anti-tumor necrosis factor alpha (TNF alpha) agents have been increasingly used to treat patients with Crohn's disease, psoriatic arthritis, rheumatoid arthritis, ankylosing spondylitis, and persistent uveitis. We describe a 68-year-old man with Crohn's esophagitis who developed a possible bilateral toxic anterior optic neuropathy during infliximab infusion.
Methods: This is an observational case report, with review of the PubMed literature from 1977 to present.
Results: This 68-year-old man with a 2-year history of Crohn's esophagitis developed acute bilateral visual loss during his third infliximab infusion. His clinical features and laboratory tests were characteristic for a bilateral anterior optic neuropathy. Only three cases of possible infliximab-associated anterior optic neuropathy have been reported in the literature to date.
Conclusion: It is important to consider the possibility of anterior optic neuropathy, in addition to retrobulbar optic neuritis, in patients who experience sudden-onset visual loss while being treated with infliximab.