Infliximab
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Demyelination associated with scotoma: case report A 38-year-old man developed a scotoma caused by occipital demyelination while receiving treatment with infliximab. The man had been diagnosed with ankylosing spondylitis (AS) with associated acute anterior HLA-B27-related uveitis in 2001 and received treatment with topical corticosteroids. By February 2009, he had disease recurrence, experiencing 3-4 attacks per year. He began systemic treatment with infusions of infliximab 5 mg/kg every 6 weeks for both AS and uveitis [route not stated]. Ten months later, he reported a blurry spot and scotoma in his left eye. Uveitis recurrence was suspected and his topical therapy was increased to a maximum dosage; however, his symptoms did not improve and he was referred to an ophthalmic clinic. His best-corrected visual acuity was light perception in the right eye (due to pre-existing myopic chorioretinal atrophy) and 1.25 in the left eye. Visual field examination detected the presence of a paracentral scotoma in the left eye. Further ocular investigations could not determine the cause of the scotoma and blurred vision. MRI showed multiple white matter substance lesions in the periventricular white matter, corpus callosum and left occipital area. The loss of vision was thought to have been caused by the lesion in the occipital area. Infliximab was discontinued. One month later, the blurred vision, scotoma and visual field in the man’s left eye had recovered. Papadia M, et al. Infliximab-induced demyelination causes visual disturbance mistaken for recurrence of HLA-B27-related uveitis. Ocular Immunology and Inflammation 18: 482-484, No. 6, Dec 2010. Available from: URL: http:// 803047406 dx.doi.org/10.3109/09273948.2010.496914 - Switzerland
0114-9954/10/1334-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Reactions 15 Jan 2011 No. 1334
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