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목적 : To investigate the role of ultra-wide-field fluorescein angiographic scoring system for monitoring the therapeutic response of adalimumab in patients with refractory Behçet’s uveitis.
방법 : Patients with refractory Behçet’s uveitis received a baseline 80 mg adalimumab subcutaneous injection and a 40 mg adalimumab injection every other week for 30 weeks. Therapeutic response was monitored at week 6, 14, and 30. Degree of retinal vasculitis was evaluated by ultra-wide-field fluorescein angiography (FA). Best corrected visual acuity (BCVA), anterior chamber cell and vitreous haze were analyzed. Immunosuppression load and systemic adverse effects were also reviewed.
결과 : Thirty-eight eyes of 20 patients with Behçet’s uveitis (M:F, 10:10) were included. Mean FA score was significantly decreased from baseline 11.11 to 7.76, 6.03, and 4.95 at week 6, 14 and 30, respectively. Among FA score, vascular leakage, capillary leakage, and retinal stain were significantly decreased. Anterior chamber cell and vitreous haze were also significantly decreased at week 6 and maintained during week 30. The BCVA was significantly improved at week 30. Adalimumab showed a steroid sparing effect (below 7.5 mg) at week 30 without notable adverse effects.
결론 : Adalimumab effectively reduced retinal vasculitis as well as anterior and posterior inflammation in refractory Behçet’s uveitis. Ultra-wide-field FA based scoring system is valuable to monitor therapeutic response of adalimumab.
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