Subconjunctival Adalimumab for Noninfectious Uveitis: A Prospective Pilot Study

To evaluate the safety and preliminary efficacy of low-dose subconjunctival adalimumab in patients with non-infectious uveitis (NIU), refractory to conventional immunomodulatory therapy (IMT). Prospective, noncomparative, interventional case series. Five patients with bilateral panuveitis (four post-therapeutic vitrectomy) and persistent intraocular inflammation on conventional IMT for > 2 years received three doses of subconjunctival adalimumab 5 mg/0.1 mL at two-week intervals and followed up for 24 weeks. No cases of persistent conjunctival congestion, corneal erosions or infection, or intraocular pressure > 21 mmHg were noted. Improvement in inflammatory scores and best-corrected visual acuity (BCVA) were noted in three patients each and worsening in none. None of the three patients who showed initial improvement in visual acuity had any baseline cystoid macular edema or vitreous haze to account for the improvement in BCVA. Subconjunctival administration of 5 mg adalimumab is a safe and effective therapy for NIU refractory to conventional IMT.