Published date: Nov 24 2022

Journal Title: Journal of Ophthalmic and Vision Research

Issue title: Oct–Dec 2022, Volume 17, Issue 4

Pages: 515–528

DOI: 10.18502/jovr.v17i4.12304

Arash Maleki

Amanda Colombo

Sydney Look-Why

Peter Chang

Stephen Anesi

C. Stephen Foster - sfoster@mersi.com

Purpose: To study whether rituximab and bortezomib combination therapy is more effective than rituximab monotherapy in the treatment of nonparaneoplastic autoimmune retinopathy (npAIR).

Methods: Retrospective case series involving six patients with npAIR, taking either rituximab and bortezomib combination therapy (three cases) or rituximab monotherapy (one case and two historical patients).

Results: Patients on both treatment regimens showed stability in most of the visual function parameters during the one year of follow-up. Combination therapy resulted in improvement of scotopic combined rod and cone a-wave and b-wave amplitudes in all eyes where they were available (four eyes); however, rituximab monotherapy resulted in only two eyes with stable scotopic combined rod and cone a-wave and b-wave amplitudes, while four eyes showed a decrease in both a- and b-wave amplitudes. The average improvement in b-wave amplitude (50.7% ± 29.4% [range 25–90%]) was higher than the average improvement in awave amplitude (35.7% ± 9.74 [range 25–63%]). No severe adverse effects were reported.

Conclusion: Rituximab and bortezomib combination therapy may not be more effective than rituximab monotherapy in npAIR patients for most of the visual function parameters; however, this combination therapy may be more effective in improving scotopic combined rod and cone a- and b-wave amplitudes. This may indicate the higher efficacy of combination therapy when there is involvement of the inner retina.

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