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Intravenous immunoglobulin in eye involvement.

Zera Tellier1

  • 1Laboratoire Francais du Fractionnement et des Biotechnologies, Les Ulis, France. tellier@lfb.fr

Clinical Reviews in Allergy & Immunology
|January 5, 2006
PubMed
Summary

Intravenous immunoglobulin (IVIg) shows promise for treating ocular inflammation, particularly uveitis, in certain autoimmune diseases. Further controlled trials are needed to confirm its efficacy and steroid-sparing potential.

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Area of Science:

  • Ophthalmology
  • Immunology
  • Rheumatology

Background:

  • Ocular inflammation, including uveitis, can significantly impair vision and is often linked to autoimmune systemic diseases.
  • Current treatments like corticosteroids and immunosuppressants have limited efficacy and significant side effects.
  • Uveitis can be the initial and most severe manifestation of underlying autoimmune conditions.

Purpose of the Study:

  • To review the existing evidence on the use of intravenous immunoglobulin (IVIg) for various forms of ocular inflammation.
  • To assess the potential benefits and limitations of IVIg in managing intraocular inflammation (IOI) associated with systemic autoimmune diseases.
  • To highlight the need for controlled clinical trials to validate IVIg's efficacy and steroid-sparing capabilities.

Main Methods:

  • Review of case series, open trials, and case reports investigating IVIg for ocular inflammation.
  • Analysis of studies focusing on specific conditions like ocular cicatricial pemphigoid, Vogt-Koyanagi-Harada syndrome, birdshot disease, and inflammatory demyelinating optic neuritis.
  • Examination of evidence for IVIg in diseases such as Wegener disease, Behcet's disease, and inflammatory myositis.

Main Results:

  • IVIg has demonstrated favorable outcomes in specific ocular inflammatory conditions, including ocular cicatricial pemphigoid, Vogt-Koyanagi-Harada syndrome, and birdshot disease.
  • Evidence for IVIg efficacy is less conclusive in conditions like inflammatory demyelinating optic neuritis.
  • Limited case reports suggest potential benefits of IVIg in Wegener disease, Behcet's disease, and inflammatory myositis.

Conclusions:

  • IVIg is a potential therapeutic option for a subset of patients with ocular inflammation, particularly those with autoimmune etiologies.
  • Controlled trials are essential to rigorously evaluate IVIg's effectiveness and its ability to reduce reliance on corticosteroids.
  • Further research is warranted to establish definitive treatment guidelines for IVIg in various intraocular inflammatory diseases.

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