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Outcomes in Autoimmune Retinopathy Patients Treated With Rituximab
Samaneh Davoudi1, Nazanin Ebrahimiadib2, Cagla Yasa1
1Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts.
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.
