Tofacitinib in Ocular Inflammation: Experience from a Tertiary Eye Centre in South India

To describe the clinical profile, efficacy, and safety profile of tofacitinib in non-infectious ocular inflammation from a tertiary eye centre in South India.

Retrospective study between 2020 and 2025.

A total of 35 cases with various inflammatory ocular diseases treated with tofacitinib were included in the study. The mean age was 45 ± 15.69 years (range: 9-71 years). There were 22 females (62.9%). Bilateral inflammation was seen in 23 cases (65.7%). The most common anatomical type of ocular inflammation was non-granulomatous anterior uveitis in 17 cases (48.57%). Associated systemic diseases were seen in 31 cases (88.6%). Spondyloarthritis was the most common systemic disease in 13 cases (40.6%). Methotrexate was the most commonly used DMARD along with tofacitinib in 24 cases (70.6%). The mean duration of therapy was 13.97 ± 12.38 months (range: 1-50 months). No activity was seen in 28 cases (77.1%), improvement in inflammation in 6 cases (17.1%), and worsening of inflammation was seen in 1 case (5.7%). In two cases, impending retinal vascular occlusions were seen which required discontinuation of tofacitinib. No other adverse effects were noted. There was no significant association between the response to tofacitinib therapy with the anatomical type of uveitis (p = 0.274) and the aetiology of uveitis (p = 0.453). There was no significant difference in the BCVA prior to starting tofacitinib and at last follow-up.

This study provides useful information on the utility of tofacitinib in different anatomical and etiologies of ocular inflammation. Due to its low costs, it is a useful drug in our therapeutic armamentarium, especially in those cases where anti-TNF agents cannot be used.