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Trabeculotomy in a Behçet's Disease Patient One Week after Infliximab Administration.

Koike A, Handa T, Zako M - Case Rep Ophthalmol (2012)

Bottom Line: The elevated intraocular pressure improved after surgery and there were no intraoperative complications.Neither ocular inflammatory attacks nor infectious complications were found in the operated eye of the patient during follow-up.Trabeculotomy one week after administration of infliximab appears to be safe and effective in treating secondary glaucoma associated with Behçet's disease.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Aichi Medical University, Nagakute, Japan.

ABSTRACT

Purpose: To describe a patient with Behçet's disease and anterior uveitis, which was not cured by local and systemic corticosteroid treatments, who underwent trabeculotomy one week after infliximab administration.

Methods: The patient received preoperative antibiotic therapy followed by trabeculotomy one week after infliximab administration. We observed ocular findings before and after surgery.

Results: Anterior uveitis improved after infliximab administration. The elevated intraocular pressure improved after surgery and there were no intraoperative complications. Neither ocular inflammatory attacks nor infectious complications were found in the operated eye of the patient during follow-up.

Conclusion: Trabeculotomy one week after administration of infliximab appears to be safe and effective in treating secondary glaucoma associated with Behçet's disease.

No MeSH data available.


Related in: MedlinePlus

Summary of the changes in the IOP and treatments for the last uveitis attack of the left eye. The first day of the last uveitis attack was defined as week 0. A line graph with open circles demonstrates representative IOPs at each period. Anterior uveitis and elevated IOP were successfully treated after preoperative infliximab administration followed by trabeculotomy one week later. Inflammation in the anterior chamber is described. Oral administration of prednisolone, levofloxacin hydrate, and isoniazid are indicated by shading, and all other agents were topically administrated. Arrows indicate IOPs before and after intravenous administration of D-mannitol and acetazolamide. PSL = Oral prednisolone (mg/day); KP = keratic precipitates; i.v. = intravenous administration of D-mannitol (500 ml) and acetazolamide (500 mg) twice a day.
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Figure 1: Summary of the changes in the IOP and treatments for the last uveitis attack of the left eye. The first day of the last uveitis attack was defined as week 0. A line graph with open circles demonstrates representative IOPs at each period. Anterior uveitis and elevated IOP were successfully treated after preoperative infliximab administration followed by trabeculotomy one week later. Inflammation in the anterior chamber is described. Oral administration of prednisolone, levofloxacin hydrate, and isoniazid are indicated by shading, and all other agents were topically administrated. Arrows indicate IOPs before and after intravenous administration of D-mannitol and acetazolamide. PSL = Oral prednisolone (mg/day); KP = keratic precipitates; i.v. = intravenous administration of D-mannitol (500 ml) and acetazolamide (500 mg) twice a day.

Mentions: Four months later, this patient came to our department again because of elevated IOP (45–50 mm Hg) with inflammation in the anterior chamber (cells 2+, flare 2+, KP 2+) and the vitreous (cells +) of his left eye (fig. 1). Oral prednisolone was increased (30 mg/day), but there was no improvement. We planned glaucoma surgery following infliximab administration. The computerized tomography to analyze his chest did not show an abnormal lesion, but his tuberculin reaction was positive; therefore, he started prophylactic isoniazid before infliximab administration.


Trabeculotomy in a Behçet's Disease Patient One Week after Infliximab Administration.

Koike A, Handa T, Zako M - Case Rep Ophthalmol (2012)

Summary of the changes in the IOP and treatments for the last uveitis attack of the left eye. The first day of the last uveitis attack was defined as week 0. A line graph with open circles demonstrates representative IOPs at each period. Anterior uveitis and elevated IOP were successfully treated after preoperative infliximab administration followed by trabeculotomy one week later. Inflammation in the anterior chamber is described. Oral administration of prednisolone, levofloxacin hydrate, and isoniazid are indicated by shading, and all other agents were topically administrated. Arrows indicate IOPs before and after intravenous administration of D-mannitol and acetazolamide. PSL = Oral prednisolone (mg/day); KP = keratic precipitates; i.v. = intravenous administration of D-mannitol (500 ml) and acetazolamide (500 mg) twice a day.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3369265&req=5

Figure 1: Summary of the changes in the IOP and treatments for the last uveitis attack of the left eye. The first day of the last uveitis attack was defined as week 0. A line graph with open circles demonstrates representative IOPs at each period. Anterior uveitis and elevated IOP were successfully treated after preoperative infliximab administration followed by trabeculotomy one week later. Inflammation in the anterior chamber is described. Oral administration of prednisolone, levofloxacin hydrate, and isoniazid are indicated by shading, and all other agents were topically administrated. Arrows indicate IOPs before and after intravenous administration of D-mannitol and acetazolamide. PSL = Oral prednisolone (mg/day); KP = keratic precipitates; i.v. = intravenous administration of D-mannitol (500 ml) and acetazolamide (500 mg) twice a day.
Mentions: Four months later, this patient came to our department again because of elevated IOP (45–50 mm Hg) with inflammation in the anterior chamber (cells 2+, flare 2+, KP 2+) and the vitreous (cells +) of his left eye (fig. 1). Oral prednisolone was increased (30 mg/day), but there was no improvement. We planned glaucoma surgery following infliximab administration. The computerized tomography to analyze his chest did not show an abnormal lesion, but his tuberculin reaction was positive; therefore, he started prophylactic isoniazid before infliximab administration.

Bottom Line: The elevated intraocular pressure improved after surgery and there were no intraoperative complications.Neither ocular inflammatory attacks nor infectious complications were found in the operated eye of the patient during follow-up.Trabeculotomy one week after administration of infliximab appears to be safe and effective in treating secondary glaucoma associated with Behçet's disease.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Aichi Medical University, Nagakute, Japan.

ABSTRACT

Purpose: To describe a patient with Behçet's disease and anterior uveitis, which was not cured by local and systemic corticosteroid treatments, who underwent trabeculotomy one week after infliximab administration.

Methods: The patient received preoperative antibiotic therapy followed by trabeculotomy one week after infliximab administration. We observed ocular findings before and after surgery.

Results: Anterior uveitis improved after infliximab administration. The elevated intraocular pressure improved after surgery and there were no intraoperative complications. Neither ocular inflammatory attacks nor infectious complications were found in the operated eye of the patient during follow-up.

Conclusion: Trabeculotomy one week after administration of infliximab appears to be safe and effective in treating secondary glaucoma associated with Behçet's disease.

No MeSH data available.


Related in: MedlinePlus