Clinical outcomes of intravenous immunoglobulin therapy in refractory uveitis

Int Ophthalmol. 2015 Apr;35(2):281-5. doi: 10.1007/s10792-015-0051-0. Epub 2015 Feb 24.

Abstract

Intravenous immunoglobulin (IVIg) therapy has multiple mechanisms of immunomodulatory action. We wished therefore to assess its efficacy in a spectrum of patients with refractory uveitis. Retrospective review of clinical charts was conducted to document response to IVIg treatment in consecutive patients with treatment-refractory uveitis. Main outcome measures were control of intraocular inflammation, visual acuity, progression of the disease, and complications. Four (two male) patients, with a mean age at the beginning of the treatment of 47 years (range: 39-64), were included in the study. Indication for treatment was patients with active non-infectious uveitis refractory to steroids and immunomodulatory therapy. All patients received a course of 0.5 g/kg per day of IVIg for three consecutive days, repeating this course at a mean of 11 week (range: 2-39 weeks) intervals when indicated clinically. The median duration of the IVIg therapy was 7 months (range: 3-14 months). In three patients treatment resulted in stabilisation and prevention of progression of the disease, and additionally in two patients it facilitated a decrease in prednisolone dose. Treatment failed to induce long-term remission in one patient with recurrence of macular oedema. IVIg was well tolerated with neither immediate nor longer-term adverse events observed. In three out of four cases IVIg was an effective adjunctive therapy and well tolerated for the management of treatment-refractory uveitis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Disease Progression
  • Female
  • Humans
  • Immunoglobulins, Intravenous / administration & dosage*
  • Immunologic Factors / administration & dosage*
  • Injections, Intravenous
  • Male
  • Middle Aged
  • Retrospective Studies
  • Uveitis / drug therapy*
  • Visual Acuity

Substances

  • Immunoglobulins, Intravenous
  • Immunologic Factors