Anti-TNF therapy for eye involvement in spondyloarthropathy

J.T. Rosenbaum, J.R. Smith

Casey Eye Institute, Oregon Health and Science University, Portland, Oregon, USA.

ABSTRACT
Approximately 40% of patients with ankylosing spondylitis or reactive arthritis will experience the sudden onset of a unilateral anterior uveitis sometime during the course of their spinal disease. In most instances, this inflammation resolves within several weeks and responds to corticosteroid and mydriatic eye drops without the need for additional therapy. A small percentage of patients with either Crohn's disease or psoriatic arthropathy will have a bilateral, chronic, anterior and/or posterior uveitis that is more refractory to therapy. A similar clinical challenge is occasionally encountered in patients with ankylosing spondylitis or reactive arthritis. In this manuscript, we review briefly the clinical manifestations of the uveitis associated with spondyloarthropathy and discuss several potential novel therapeutic approaches, primarily anti-tumor necrosis factor (TNF) therapy.

Key words
Uveitis, TNF, monoclonal antibody.

Dr. Rosenbaum is supported in part by the National Institute of Health (EYO6484), Research to Prevent Blindness and the Rosenfeld Family Fund. Dr. Smith is supported by a Career Development Award from Research to Prevent Blindness. Drs. Rosenbaum and Smith are co-investigators on a study with Centocor to examine infliximab for the treatment of uveitis and with Bausch and Lomb on a study of a corticosteroid implant for uveitis.
Please address correspondence to: Dr. James T. Rosenbaum, Casey Eye Institute, Oregon Health & Science University, 3375 Terwilliger Blvd, Portland, Oregon, USA 97201-4197, USA. 
E-mail address: rosenbaj@ohsu.edu

Clin Exp Rheumatol 2002; 20: (Suppl. 28): S143-S145.
© Copyright Clinical and Experimental Rheumatology 2002.