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Rituximab for refractory granulomatous eye disease
Elyse E Lower1, Robert P Baughman, Adam H Kaufman
1Department of Medicine, University of Cincinnati Medical Center, Cincinnati, OH, USA ; Oncology Hematology Care, Cincinnati, OH, USA.
Clinical Ophthalmology (Auckland, N.Z.)
|October 12, 2012
Summary
Rituximab effectively treated granulomatous eye disease in most patients, reducing the need for corticosteroids. This therapy proved beneficial for refractory cases of ocular vasculitis and sarcoidosis.
Area of Science:
- Ophthalmology
- Rheumatology
- Immunology
Background:
- Granulomatous diseases of the eye, including ocular vasculitis and sarcoidosis, can cause persistent ocular inflammation.
- Systemic therapies are often insufficient for managing refractory ocular manifestations.
Observation:
- A retrospective review identified nine patients with severe ocular granulomatous disease refractory to conventional treatment.
- Patients received rituximab therapy for at least six months.
Findings:
- Eight of nine patients experienced significant improvement in ocular disease, allowing for reduction in corticosteroid and other immunosuppressive medications.
- All five patients with concurrent pulmonary involvement showed improvement.
- Rituximab was generally well-tolerated, with two patients discontinuing due to leukopenia but later resuming therapy at reduced doses.
Implications:
- Rituximab demonstrates significant efficacy in managing refractory granulomatous ocular diseases, including antineutrophil cytoplasmic antibody-associated vasculitis and sarcoidosis.
- The therapy offers a corticosteroid-sparing effect, crucial for minimizing long-term steroid-related toxicities.
- Rituximab represents a valuable therapeutic option for severe, treatment-resistant ocular inflammatory conditions.