Outcomes in Autoimmune Retinopathy Patients Treated With Rituximab Publisher Pubmed



Davoudi S¹ ; Ebrahimiadib N^{1, 2} ; Yasa C¹ ; Sevgi DD¹ ; Roohipoor R^{1, 2} ; Papavasilieou E¹ ; Comander J¹ ; Sobrin L¹ Show Affiliations
Source: American Journal of Ophthalmology Published:2017

Abstract

Purpose To evaluate clinical and ancillary testing, including adaptive optics, outcomes in autoimmune retinopathy (AIR) patients treated with rituximab. Design Retrospective, interventional case series. Methods PATIENTS: Sixteen AIR patients treated with rituximab. OBSERVATION PROCEDURES: All patients were treated with a loading and maintenance dose schedule of intravenous rituximab. Visual acuity (VA), electroretinography (ERG), and spectral-domain optical coherence tomography (SDOCT) and visual field (VF) results were recorded. A subset of patients was also imaged using adaptive optics scanning laser ophthalmoscopy (AO-SLO). MAIN OUTCOME MEASURES: Rates of VA change before vs after rituximab initiation were compared with mixed-model linear regression. Results The rate of visual decline was significantly less after rituximab initiation compared with the rate of visual decline prior to rituximab initiation (P =.005). Seventy-seven percent of eyes had stable or improved VA 6 months after rituximab initiation. Amplitudes and implicit times on ERG, mean deviation on VF, central subfield mean thickness, and total macular volume did not decrease to a significant degree over the rituximab treatment period. Six eyes had serial AO-SLO imaging. Cone densities did not change significantly over the treatment period. Conclusion VA was stable or improved in a majority of AIR patients while they were being treated with rituximab. OCT and ERG parameters, as well as AO-SLO cone densities, were stable during treatment. Studies with additional patients and longer follow-up periods are needed to further explore the utility of rituximab in the management of AIR. © 2017 Elsevier Inc.