The Effect of Adalimumab on Refractory Uveitis

Purpose@#To assess the efficacy and safety of Adalimumab (Humira®, AbbVie, Chicago, IL, USA) for repeated refractory uveitis during systemic steroid or immunosuppressive therapy. @*Methods@#We retrospectively reviewed clinical records on 30 eyes of 18 patients with non-infectious refractory uveitis who underwent Adalimumab injection therapy from December 2017 to July 2019. The therapeutic effect was assessed based on intraocular inflammation grade, central macular thickness, and best corrected visual acuity, and the efficacy was assessed based on control of inflammation and macular edema, as well as corticosteroid sparing effects. The safety was assessed based on adverse events. @*Results@#The mean duration of uveitis at baseline was 55.4 months (13-121 months) and the mean follow-up was 9.2 months (6-18 months). All 30 eyes of 18 patients stopped using systemic steroids and maintained clinical quiescence. Anterior chamber inflammation, vitreous inflammation, and best corrected visual acuity showed significant improvement, and there was no difference in central macular thickness. Uveitis recurred in 5 eyes, but 4 eyes showed controlled inflammation after single posterior sub-tenon steroid injection. One eye was controlled after methotrexate co-administration. Ulticaria (two patients) and injection- site reaction (one patient) were reported as adverse events. @*Conclusions@#Adalimumab is an effective treatment for decreasing inflammatory activity and reducing corticosteroid burden in refractory uveitis.

The Role of Nitric Oxide in the Cataract Development: A Possible Mechanism of Lens Opacity

PURPOSE: To assess the role of nitric oxide in the development of cataract by detection of nitrotyrosine, which is a reaction product of peroxynitrite with tyrosine. METHODS: We have collected aqueous humor and anterior capsule of lens after cataract surgery from 14 eyes. We classified lens opacities into three types such as nuclear sclerosis, cortical and posterior subcapsular opacity. Nitrite, stable oxidative product of nitric oxide, was measured in the aqueous humor and immunohistochemical staining for nitrotyrosine was performed to examine anterior capsules. RESULTS: The concentrations of nitric oxide in aqueous humor were 0.0698+/-0.0036, 0.0652+/-0.0116, and 0.0700+/-0.0022 mM in nuclear sclerosis, cortical and posterior subcapsular opacity, respectively and no significant differences existed among lens opacity types. In lenses with cortical and posterior subcapsular opacity, the expression of nitrotyrosine was observed around epithelial cell and intercellular space. There was no expression of nitrotyrosine in lenses with nuclear sclerosis. CONCLUSIONS: This results suggest that nitration of tyrosine by peroxynitrite is possibly related to the cataractogenesis of lenses with cortical and posterior subcapsular opacity.

Vitreous Biopsy Using You's bottle: Safety and Effectiveness

PURPOSE: To evaluation of the safety and the usefulness of our "You's bottle" that we have invented for sampling vitreous. METHODS: We performed the vitreous sampling with our collection bottle in 13 patients who had undergone vitrectomy for diabetic retinopathy. We observed the usefulness and complications after sampling. Collected vitreous was used for analysis of protein components. RESULTS: There was no complication associated with collection bottle. The analysis of proteome was successful. CONCLUSIONS: Our study showed that "You's bottle" might be a useful tool for the research of vitreous.