Sanghi, Priyanka; Luis, Joshua; Ajamil, Sofia; Yeung, Ian YL; Hindle, Edward; Sandhu, Selina; Hassan, Said; ... Westcott, Mark; + view all Sanghi, Priyanka; Luis, Joshua; Ajamil, Sofia; Yeung, Ian YL; Hindle, Edward; Sandhu, Selina; Hassan, Said; Ben, Turner; Rees, Angela; Westcott, Mark; - view fewer (2022) Predictive Factors for Magnetic Resonance Imaging Changes Suggestive of Demyelination in Adult Patients with Uveitis Scanned Prior to Commencing Adalimumab Therapy. Ocular Immunology and Inflammation 10.1080/09273948.2022.2118134. (In press).

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Abstract

PURPOSE: To report the predictive clinical factors for abnormal magnetic resonance imaging (MRI) scans suggestive of demyelination by analysis of MRI’s performed for adult non-infectious uveitic patients prior to commencing adalimumab therapy. METHODS: Retrospective case review of 240 patients was conducted in a single tertiary institution between November 2017 and March 2020. Aetiology of underlying disease, clinical characteristics, and MRI outcomes were analysed. RESULTS: The presence of bilateral idiopathic intermediate uveitis (IIU) (p = .0048) and neurological symptoms (p = .028) were highly predictive of an abnormal MRI strongly suggestive of demyelination (MRSSD); 5 out of 64 scans (7.8%) with these clinical characteristics had MRSSD. CONCLUSIONS: Tumor necrosis factor antagonist-induced demyelination is a concern in adalimumab use. We propose an MRI screening protocol to identify those at high risk of demyelination; positive results can be maximised by screening all patients with IIU and those with neurological symptoms.

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