Objective: Various demyelinating disorders have been reported in association with anti- tumor necrosis factor-α (TNF-α) agents. The objective of this study was to review the occurrence, clinical features, and outcome of optic neuritis (ON) during treatment with anti-TNF-α agents.
Methods: A PubMed search was conducted to identify literature addressing the potential association between anti-TNF-α agents and ON, following our experience with a patient having rheumatoid arthritis in whom the ON was developed while being treated with infliximab.
Results: Total of 15 patients including the case presented here with ON in whom the symptoms developed following TNF-α antagonist therapy were evaluated. Eight of these patients had received infliximab, 5 had received etanercept, and 2 patients had received adalimumab. Among them, 9 patients experienced complete resolution, and 2 patients had partial resolution, while 4 patients continued to have symptoms.
Discussion: Patients being treated with TNF-α antagonist should be closely monitored for the development of ophthalmologic or neurological signs and symptoms. Furthermore, consideration should be given to avoiding such therapies in patients with a history of demyelinating disease. If clinical evaluation leads to the diagnosis of ON, discontinuation of the medication and institution of the steroid treatment should be foremost.
- optic neuritis