Fluorescein and OCT Angiography Features of Takayasu Disease.

Purpose: Evaluate OCT (optical coherence tomography) angiography (OCTA) features in patients with Takayasau disease. Methods: The OCTA was analyzed to evaluate perifoveal anastomatic capillary arcade disruption, microaneurysms. The foveal avascular zone (FAZ) was measured for superficial (SCP) and deep capillary plexus. Results: There were 26 eyes included. In OCTA, 11 eyes presented ruptures of the perifoveal anastomotic capillary arcade in SCP. A total of 5 had microaneurysms. The average SCP FAZ was increased to 0.34 mm2 in Takayasu compared to 0.27 mm2 in control patients. Conclusion: Fluorescein angiography is the gold standard to describe Takayasu retinopathy ischemic signs. Macular abnormalities are uncommon in Takayasu patients as retinopathy signs are mostly located in peripheral retina. This study reveals that most of our patients present an enlargement of the FAZ then highlights the relevance of OCTA to evaluate macular ischemia as a complement to usual retina global study in fluorescein angiography.

Expert opinion on the use of biological therapy in non-infectious uveitis.

INTRODUCTION: Conventional immunosuppressive drugs, anti-TNF alpha treatments and biotherapies are increasingly being used in non-infectious uveitis. AREAS COVERED: The present work was led by a multidisciplinary panel of experts, including internal medicine specialists, rheumatologists and ophthalmologists, and proposes an extensive review on the use of biological agents in non-infectious uveitis. EXPERT OPINION: In case of dependency to steroids or sight-threatening disease, conventional immunosuppressive drugs (methotrexate, azathioprine and mycophenolate mofetil) and/or biological therapies such as anti-TNF alpha treatments (adalimumab, infliximab) can be used to achieve and maintain disease quiescence. Interferon is an efficient immunomodulatory drug that can be proposed as second-line therapy in specific indications (eg. refractory macular edema, sight-threatening Behçet's uveitis). Other biologics, especially tocilizumab, are showing promising results. Local treatments (steroids, sirolimus etc.) can be used as adjuvant therapies in case of unilateral relapse. Therapeutic response must always be evaluated by clinical examination and appropriate ancillary investigations.

Long-term Efficacy of Interferon in Severe Uveitis Associated with Behçet Disease.

PURPOSE: To retrospectively assess the frequency of ocular relapse and the possibility of long-term remission in patients treated with interferon (IFN) for severe uveitis associated with Behçet disease. METHODS: All patients were treated with an initial dosage of 3 million IU IFN three times a week. The main outcome measure was the number of relapses per person per year before, during, and after IFN treatment. RESULTS: Of 36 patients (67 eyes), 31 (86.1%) responded to IFN. The mean follow-up was 8.19 years. Twenty-one out of 36 patients discontinued IFN and 76% of these have not relapsed within 5.05 years after discontinuation. The mean relapse per person per year decreased significantly from 1.39 to 0.0496 (p = 1.82×10-10) during the treatment period and remained at 0.057 relapses per person per year after IFN discontinuation. CONCLUSION: IFN efficiently decreases the relapse rate and seems to permit long-term remission even after discontinuation.