Corneal Adverse Events Temporally Associated with Anti-TNF-α Therapy: Severe Fibrovascular Pannus and a Non-Pannus Epitheliopathy in Two Cases.

IF 0.7 Q3 MEDICINE, GENERAL & INTERNAL
International Medical Case Reports Journal Pub Date : 2025-10-09 eCollection Date: 2025-01-01 DOI:10.2147/IMCRJ.S548235
Natsuko Mori, Akira Kobayashi, Hideaki Yokogawa, Tomomi Higashide
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引用次数: 0

Abstract

Purpose: To describe two corneal adverse events temporally associated with anti-tumor necrosis factor-α (TNF-α) therapy-one with severe fibrovascular pannus and another with epithelial keratopathy without pannus.

Methods: Two patients on anti-TNF-α agents underwent comprehensive ocular examinations. Management included modification or discontinuation of biologics as clinically indicated and intensified topical therapy.

Results: Case 1 (pustular psoriasis on adalimumab) developed bilateral fibrovascular pannus with stromal changes. Ocular findings did not improve immediately after adalimumab discontinuation but gradually improved following macrolide, topical corticosteroid, and immunomodulatory therapy. Case 2 (Crohn's disease on adalimumab then golimumab) presented with superior corneal haze and diffuse superficial punctate keratopathy without pannus and resolved with topical therapy alone.

Conclusion: These cases raise the possibility that corneal adverse events-including severe pannus-may occur during anti-TNF-α therapy. Given the heterogeneity and potential confounders, causality cannot be established. Ophthalmic vigilance and further studies are warranted.

与抗tnf -α治疗相关的角膜不良事件:2例严重纤维血管瘤和非瘤状上皮病。
目的:描述两种与抗肿瘤坏死因子-α (TNF-α)治疗暂时性相关的角膜不良事件,一种是严重的纤维血管性潘潘,另一种是无潘潘的上皮性角膜病变。方法:对2例使用抗tnf -α药物的患者行眼部综合检查。治疗包括修改或停止生物制剂的临床指征和加强局部治疗。结果:病例1(阿达木单抗治疗的脓疱性银屑病)出现双侧纤维血管管状瘤伴间质改变。阿达木单抗停药后,眼部症状没有立即改善,但在大环内酯、局部皮质类固醇和免疫调节治疗后逐渐改善。病例2(克罗恩病先用阿达木单抗,后用戈利木单抗)表现为上角膜混浊和弥漫性浅表性点状角膜病变,无pannus,仅局部治疗即可解决。结论:这些病例增加了抗tnf -α治疗期间可能发生角膜不良事件(包括严重的pannus)的可能性。考虑到异质性和潜在的混杂因素,无法建立因果关系。眼科的警惕和进一步的研究是必要的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
International Medical Case Reports Journal
International Medical Case Reports Journal MEDICINE, GENERAL & INTERNAL-
CiteScore
1.40
自引率
0.00%
发文量
135
审稿时长
16 weeks
期刊介绍: International Medical Case Reports Journal is an international, peer-reviewed, open access, online journal publishing original case reports from all medical specialties. Submissions should not normally exceed 3,000 words or 4 published pages including figures, diagrams and references. As of 1st April 2019, the International Medical Case Reports Journal will no longer consider meta-analyses for publication.
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