J Korean Ophthalmol Soc.  2008 Oct;49(10):1690-1695.

A Case Report of Intractable Scleritis Effectively Treated with Infliximab

• Kim DH
• Wee WR
• Lee JH
• Kim MK

Abstract

PURPOSE
To report a case of a patient with intractable scleritis with conventional immunosuppressive therapy who showed effective treatment with infliximab.
CASE SUMMARY
A 71-year-old man presented with orbital cellulitis and diffuse anterior scleritis of his left eye. Although orbital cellulites showed remission with topical and systemic antibiotics, scleritis persisted despite a combination therapy of immunosuppressive agents (cyclosporin, mycophenolate, prednisolone) for 1 month. Finally, he was given infliximab (5 mg/kg) intravenously three times at 2-week intervals, after which ocular pain, chemosis, conjunctival injection, and sclera thickening considerably reduced, and scleritis completely remitted.
CONCLUSIONS
The administration of Infliximab seems to be an effective therapy in patients with intractable scleritis undergoing conventional therapy.

Keyword

Infliximab; Scleritis; TNF-a

MeSH Terms

Aged
Anti-Bacterial Agents
Antibodies, Monoclonal
Eye
Humans
Immunosuppressive Agents
Orbit
Orbital Cellulitis
Sclera
Scleritis
Infliximab
Anti-Bacterial Agents
Antibodies, Monoclonal
Immunosuppressive Agents

Figure

• 

  Figure 1. Swelling and redness in the left eyelid were noted at the first visit.

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  Figure 2 . Twenty-six days after treatment, swelling and redness in the left eyelid resolved.

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  Figure 3 . Seven days after treatment, diffuse scleral inflammation, conjunctival injection, nasal calcium plaque were noted.

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  Figure 4 . Seven days after treatment, choroidal and retinal detachment and scleral thickening were noted on ultrasonogram (B-scan).

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  Figure 5. Twenty-six days after treatment, stationary scleral inflammation and slightly improved conjunctival injection were noted after conventional immunosuppressive therapy.

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  Figure 6. Twenty-six days after treatment, no choroidal and retinal detachment was noted, but posterior scleral thickening was persistent on ultrasonogram (B-scan) after conventional immunosuppressive therapy.

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  Figure 7. At 138 days after treatment, scleral inflammation and conjunctival injection completely resolved after infliximab therapy.

Reference

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