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Maleki A, Colombo A, Look-Why S, Chang P, Anesi S, Foster CS. Rituximab Monotherapy versus Rituximab and Bortezomib Combination Therapy for Treatment of Non-paraneoplastic Autoimmune Retinopathy. JOVR [Internet]. 2022Nov.24 [cited 2024Jul.27];17(4):515–528. Available from: https://knepublishing.com/index.php/JOVR/article/view/12304

https://doi.org/10.18502/jovr.v17i4.12304

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authors

  • Arash Maleki

    Arash Maleki

    Massachusetts Eye Research and Surgery Institution, Waltham, MA, USA
  • Amanda Colombo

    Amanda Colombo

    Massachusetts Eye Research and Surgery Institution, Waltham, MA, USA
  • Sydney Look-Why

    Sydney Look-Why

    Massachusetts Eye Research and Surgery Institution, Waltham, MA, USA
  • Peter Chang

    Peter Chang

    Massachusetts Eye Research and Surgery Institution, Waltham, MA, USA
  • Stephen Anesi

    Stephen Anesi

    Massachusetts Eye Research and Surgery Institution, Waltham, MA, USA
  • C. Stephen Foster

    C. Stephen Foster

    Massachusetts Eye Research and Surgery Institution, Waltham, MA, USA

Published Date

  • Nov 24, 2022
This journal is publishing all the articles under Creative Commons Attribution License CC BY 4.0.

Rituximab Monotherapy versus Rituximab and Bortezomib Combination Therapy for Treatment of Non-paraneoplastic Autoimmune Retinopathy

Journal of Ophthalmic and Vision Research (JOVR) / Oct–Dec 2022, Volume 17, Issue 4 / Pages 515–528

Abstract

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.

Keywords:

Autoimmune Retinopathy, Bortezomib, Electroretinography, Nonparaneoplastic AIR, Rituximab, Visual Field

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