LAUSR

PURPOSE To study the safety of extended monthly intravitreal infliximab injections in patients with active posterior uveitis in Behcet's disease (APUBD). METHODS This is a prospective, interventional, noncomparative, open-label, pilot study of 9 monthly intravitreal infliximab injections (1mg/0.05ml) for twenty-two eyes of 16 patients with APUBD. Control of inflammation and visual outcomes were assessed, and ocular complications were monitored during the study period. RESULTS Successful treatment was achieved in 7 eyes (35%) and failure was encountered in 13 eyes (65%). Only seven eyes of 6 patients (35%) had completed the study and achieved complete resolution of inflammation with improved BCVA, and no complications. Failure was either due to inability to control the inflammation in 9 eyes (45%) or development of exacerbation of inflammation in 4 eyes (20%). Four eyes developed severe immunological reaction from the drug following first (n=1), second (n=2), and third (n=1) injections and had to discontinue the injections. Kaplan-Meier survival analysis showed that the mean estimated time to failure was 3.3±0.2 months and all failed eyes required revision of their systemic immunotherapy to control the ocular inflammation. CONCLUSION Intravitreal infliximab for APUBD was associated with a high complication rate and failure to control inflammation in the majority of eyes. It should not be considered a substitute to systemic therapy.