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Systemic Lupus Erythematosus-associated Retinal Vasculitis Treated with Adalimumab

Author

Ocul Immunol Inflamm. 2020 Nov 16;1-5. doi: 10.1080/09273948.2020.1828937.Online ahead of print.

Sanjana Kuthyar 1, Alexander C Barnes 1, Javeria Bhawal 2, Joseph Christiansen 1, Jessica G Shantha 1, Steven Yeh 1

Author Information

1 Emory Eye Center, Emory University School of Medicine , Atlanta, GA, USA.

2 Rheumatology, Piedmont Atlanta Hospital , Atlanta, GA, USA.

Abstract

Purpose: To present a case of refractory systemic lupus erythematosus (SLE)-associated retinal vasculitis that responded to the anti-tumor necrosis factor (TNF)-alpha inhibitor adalimumab as corticosteroid-sparing therapy.

Methods: Descriptive case report of a patient with SLE with retinal vasculitis complicated by an ischemic retinal vein occlusion and cystoid macular edema.

Results: A 30-year-old female patient with a history of SLE presented with retinal vasculitis and an ischemic, branch retinal vein occlusion with macular edema in the left eye. Oral corticosteroid was administered along with mycophenolate mofetil (MMF) as a corticosteroid-sparing agent. Despite MMF therapy, the patient developed an exacerbation of her vasculitis with the involvement of both eyes. Adalimumab was initiated with a resultant resolution of retinal vasculitis as a corticosteroid-sparing strategy with over 2 years of follow-up.

Conclusion: Anti-TNF-alpha therapy with adalimumab may be effective as a corticosteroid-sparing agent in select patients with ocular inflammation associated with SLE.