Clinical course of patients with immuno-inflammatory ocular disease treated with Campath-1H (C1H) monoclonal antibody
| Age (years) | Diagnosis | C1H indication | Previous therapy | C1H dose (mg) | Current clinical status | Current daily therapy | Follow up (months) | |||||||||
| 1 | 70 | Rheumatoid sclerokeratitis: left recurrent corneal graft rejection | Refractory to treatment | Pred, Aza, CsA | 60 | Clear graft for 24 months, then proteus keratitis resulting in enucleation of left eye | Pred (7.5 mg) CsA (2.5 mg/kg) |
72 | ||||||||
| Melt right eye, controlled with CsA | ||||||||||||||||
| 2 | 39 | Diabetic proliferative retinopathy: recurrent corneal graft rejection and secondary glaucoma | Refractory to treatment Toxicity |
Pred, Aza, CsA | 120 | Clear graft | Pred (8 mg) No antiglaucoma medication |
25 | ||||||||
| 3 | 68 | Wegener's granulomatosis: scleritis/PUK/perforated globe | Refractory to treatment | Pulsed IV methylpred, cyclo | 60 | Resolution of PUK, and ENT symptoms | Pred (10 mg) | 8 | ||||||||
| 4 | 61 | Wegener's granulomatosis: orbital pseudotumour | Refractory to treatment | Pred, Cyclo, Aza, cycloph, Dxt | 60 (5/97) | Initially improved Relapse requiring 2nd course, followed by improved orbital disease and resolution of pseudotumour on CT scan |
Pred (5 mg alternate days) | 12 (from 2nd course) | ||||||||
| 150 (4/98) | ||||||||||||||||
| 5‡ | 46 | Non-infectious retinal vasculitis | Toxicity Refractory to treatment |
Pred, Aza, CsA, IvIg | 60 | Improved | Pred (15 mg) at time of death | 15 (died, mycocardial infarction) | ||||||||
| 6 | 58 | Non-infectious retinal vasculitis | Toxicity | Pred, Aza, CsA | 60 | Improved (relapse of anterior uveitis only) | Pred (5 mg) | 22 | ||||||||
| Refractory to treatment | FK 506 (0.05 mg/kg) | |||||||||||||||
| 7 | 38 | Non-infectious retinal vasculitis | Refractory to treatment | Pred, MM, CsA | 60 | Improvement | Pred (15 mg) | 5 | ||||||||
| Toxicity | Relapse anterior uveitis only | |||||||||||||||
| 8 | 57 | Sympathetic ophthalmia | Refractory to treatment | Pred, CsA | 60 | No further deterioration | Pred (10 mg) | 5 | ||||||||
| Toxicity (CyA) | Blood pressure and renal function stabilised off CsA | |||||||||||||||
| 9 | 51 | Behçet's disease | Refractory to treatment Toxicity |
Pred, Aza, CsA | 50 | Improved retinal inflammation Relapse anterior uveitis only |
CsA Pred Thalidomide |
18 | ||||||||
| Stable CNS signs | ||||||||||||||||
| 10 | 42 | Non-infectious retinal vasculitis | Refractory to treatment, other eye enucleated from secondary rubeotic glaucoma 6 years previously | Pred, CsA, Aza | 60 | Improvement and resolution of rubeosis | Pred (7 mg) CsA (200 mg) |
14 | ||||||||
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↵Improvement was noted by one or more of resolution of orbital clinical signs; maintained clarity of corneal graft and no further rejection episodes; resolution of vasculitic peripheral corneal melting episodes; improved visual acuity; resolution of intraocular inflammation.
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↵ ‡Previously published case reports. Now longer follow up.8 9
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PUK = peripheral ulcerative keratitis; Pred = prednisolone; Aza = azathioprine; CsA = cyclosporin A; Cyclo = cyclophosphamide; Dxt = radiotherapy; IvIg = intravenous gammaglobulins; MM = mycophenolate mofetil.
