Purpose: To describe the clinical outcome of refractory ocular Behçet disease with adalimumab therapy. Method: Retrospective review of records. Results: Twenty-one eyes of 11 male patients with ocular Behçet disease received adalimumab therapy. Of the 21 eyes, 17 had improvement of visual acuity by more than 3 lines after the average follow-up of 10.8 months. Ten out of 11 patients showed complete resolution of inflammation by 4 weeks. The dosages of corticosteroids and immunosuppressive drugs were reduced in most of the patients and stopped altogether in 3 and 6 patients, respectively. One patient on infliximab showed improvement of inflammation after switching over to adalimumab. No serious side effects were observed in any of the patients. Conclusion: Adalimumab appears to be effective in Behçet disease. It has been shown to improve visual acuity and also to have a corticosteroid and immunosuppressive sparing effect. It can induce and maintain sustained remission of the disease.
To validate the web weight gain-based WINROP (weight, insulin-like growth factor I, neonatal, retinopathy of prematurity [ROP]) algorithm retrospectively to identify type 1 ROP in a Saudi cohort of premature infants. Methods: The records of preterm infants (greater than 23 and less than 32 weeks gestation) born between August 2013 and October 2018, were reviewed. Birth weight, gestational age, and weekly weight measurements of the premature infants were entered online. Based on weekly weight gain, the WINROP algorithm alerted clinicians whether infants were at high-risk for vision‑threatening type 1 ROP. Sensitivity, specificity, positive and negative predictive values were calculated. Results: The median gestational age of the infants at birth was 28 weeks, with median birth weight at 1085 g. Of the 175 infants included in the study, 13 (7.4%) developed type 1 ROP. WINROP positive alarm was triggered in 70.9% (124/175) of all infants and 100% (13/13) of those treated for type 1 ROP. The specificity of the algorithm was 31.5%. Positive predictive values was 10.5% and negative was 100%. Conclusion: The general WINROP sensitivity in identifying type 1 ROP was 100% similar to that reported in developed countries; however, its specificity was low at 31.5%. Tweaking of the algorithm based on the population may increase the specificity and promote the practical utility of this non-invasive screening tool for ophthalmologists and neonatologists in this population.
Our objective is to report a case of bilateral nodular scleritis in a 34-year-old patient, resistant to steroids and traditional disease modifying anti-rheumatic drugs, who was successfully treated with subcutaneous injections of 40 mg adalimumab. Adalimumab resulted in rapid control of scleritis in both eyes within 3 months with no recurrence over 5 years of follow-up. No side effects were reported during treatment. Although a large prospective study and a longer follow-up are required to reach a conclusive result, adalimumab has a potential role in the treatment of the above condition with the control of inflammation.