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Updated: Sep 19, 2025

Retinal Pigment Epithelium Transplantation in a Non-human Primate Model for Degenerative Retinal Diseases

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Paradoxical Exacerbation of Birdshot Retinochoroiditis Following Rituximab.

Anamika Patel¹, Chi Yun Doreen Ho¹, William Tucker¹

¹Uveitis Department, Moorfields Eye Hospital, London, UK.

Ocular Immunology and Inflammation

|June 18, 2025

Summary

Rituximab treatment for Birdshot Retinochoroiditis may paradoxically worsen ocular inflammation. This case report details a patient experiencing increased inflammation after rituximab, requiring steroid treatment and drug discontinuation.

Keywords:

Birdshot retinochoroiditis OCT paradoxical reaction rituximab

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Area of Science:

Ophthalmology
Immunology

Background:

Birdshot Retinochoroiditis is a chronic inflammatory eye disease.
Rituximab is an immunosuppressive drug used in various autoimmune conditions.

Purpose of the Study:

To report a case of exacerbated ocular inflammation following rituximab treatment in a patient with Birdshot Retinochoroiditis.

Main Methods:

Retrospective single case report.
Utilized enhanced depth imaging optical coherence tomography (EDI-OCT), Indocyanine green angiography (ICGA), and electroretinography (ERG) for diagnosis and monitoring.

Main Results:

Patient developed increased choroidal thickness, retinal pigment epithelium undulations, and subretinal fluid post-rituximab.
ICGA showed obscured choroidal vessels and diffuse late hyperfluorescence.
ERG indicated retinal dysfunction.

Conclusions:

Rituximab may cause paradoxical intraocular inflammation exacerbation in Birdshot Retinochoroiditis.
This phenomenon, though reported elsewhere, is rare in ophthalmology.