The Effectiveness of Infliximab in Controlling Uveitis in Behçet s Disease Following Vitrectomy Operation

Introduction: Infliximab is a chimeric monoclonal antibody inhibiting TNF-α essential for rapid and effective suppression of the acute ocular inflammation and extraocular manifestations of Behçet disease. Aim of the Work: Was to describe the effectiveness of infliximab in controlling ocular manifestations in Behçet s Disease (BD) patients following vitrectomy operation. Patients and Methods: Twenty two male adult BD patients, diagnosed according to the International study group for Behçet s disease in 1990 were included in the present study. All patients were candidates for vitrectomy due to their severe refractory posterior uveitis not responding to immunosuppressive drugs. The age of the patients ranged between 25.5-42.1 years and disease duration ranged between 2.1-10.3 years. Full history taking, clinical examination and laboratory investigations performed to all patients. Disease activity was assessed using the Behçet s Disease Current Activity Form (BDCAF) score. Each patient underwent complete ophthalmologic examination, which included the best corrected visual acuity testing (VA), slit-lamp biomicroscopy, tonometry, and indirect ophthalmoscopy. Other investigations including fundus photography, fluorescein angiography, and ultrasonography were performed as indicated. Infliximab was given in a dose of 5 mg/kg intravenous infusion over a three-hour period once every two weeks for 3 treatment sessions. Results: Improvement of ocular manifestations were detected after Infliximab treatment regimen in 20 patients The mean VA of the patients improved (p=0.0113). ESR and dose of steroids significantly decreased following Infliximab treatment. (p=0.0014 and 0.0001 respectively). Conclusion: Infliximab treatment is effective in controlling ocular manifestations, following vitrectomy in BD patients.