Efficacy of Rituximab Treatment in Vogt-Koyanagi-Harada Disease Poorly Controlled by Traditional Immunosuppressive Treatment

Ocul Immunol Inflamm. 2022 Aug;30(6):1303-1308. doi: 10.1080/09273948.2021.1880604. Epub 2021 Apr 1.

Abstract

Purpose: To evaluate the efficacy of Rituximab (RTX) therapy in patients affected by Vogt-Koyanagi-Harada (VKH) disease poorly controlled by traditional immunosuppressive treatment.

Methods: Retrospective case series of recurrent VKH uveitis treated with intravenous RTX between January 2019 and November 2020. All patients were treated with intravenous RTX and underwent complete ophthalmic examination, best-corrected visual acuity (BCVA), fundus photography, subfoveal choroidal thickness (SFCT) measurement on enhanced depth imaging optical-coherence tomography (EDI-OCT), fluorescein, and indocyanine green angiography.

Results: Five patients were included. All patients received at least 3 RTX infusions. Mean BCVA improved from 20/32 Snellen equivalent at baseline before RTX treatment to 20/28 Snellen equivalent (p = .008). Mean SFCT on EDI-OCT showed a reduction from 564.4 µm(SD = 176.2) to 280.0 µm(SD = 140.4) (p = .015). Follow-up ranged from 12 to 21 months, with a mean of 18.2 ± 3.7 months.

Conclusions: In these case series, RTX was effective in VHK disease poorly controlled by traditional immunosuppressive treatment.

Keywords: RTX; Rituximab; VKH; Vogt-Koyanagi-Harada; uveitis.

MeSH terms

  • Choroid
  • Fluorescein Angiography / methods
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Retrospective Studies
  • Rituximab / therapeutic use
  • Tomography, Optical Coherence / methods
  • Uveomeningoencephalitic Syndrome* / diagnosis
  • Uveomeningoencephalitic Syndrome* / drug therapy

Substances

  • Rituximab
  • Immunosuppressive Agents