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Related Experiment Videos

Adverse events after intravitreal infliximab (Remicade).

Monica Giganti¹, Paul M Beer, Nicole Lemanski

¹Retina Consultants PLLC, Slingerlands, NY, USA. drgiganti@retinaconsultant.org

Retina (Philadelphia, Pa.)

|December 10, 2009

Summary

This summary is machine-generated.

Intravitreal infliximab (Remicade) showed poor tolerability in patients with refractory diabetic macular edema and age-related macular degeneration. The treatment was immunogenic and likely retinotoxic, leading to vision decline and inflammation.

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Area of Science:

Ophthalmology
Retinal Diseases
Immunology

Background:

Diabetic macular edema (DME) and choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD) are leading causes of vision loss.
Conventional therapies for refractory DME and CNV may not be effective for all patients.

Observation:

A pilot study evaluated intravitreal infliximab in four patients with refractory DME or AMD-related CNV.
Patients received low-dose intravitreal infliximab, with eligibility for a second injection.
Outcome measures included visual acuity, optical coherence tomography (OCT), fluorescein angiography, electroretinography (ERG), and microperimetry.

Findings:

Intravitreal infliximab led to vision decline in most patients.
Persistent cystoid macular edema was observed on OCT, with decreased retinal thickness in some.
All patients experienced worsened ERG and microperimetry results.
Three patients developed systemic antibodies against infliximab (human antichimeric antibodies).
Inflammation, including vitritis and panuveitis, occurred in three patients, one after a second injection.

Implications:

Low-dose intravitreal infliximab was not well tolerated in this patient cohort.
The treatment demonstrated immunogenicity and potential retinotoxicity.
Further research is needed to explore alternative treatments for refractory DME and AMD-related CNV.