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Bilateral Retrobulbar Optic Neuropathy Associated With Golimumab

de Frutos-Lezaun, Marta MD*; Bidaguren, Aritz MD*; de la Riva, Patricia MD†; Meneses, Carlos F. MD‡; Olascoaga, Javier MD, PhD†

doi: 10.1097/WNF.0000000000000211
Case Reports

Abstract: We report the first documented case of retrobulbar optic neuropathy associated with golimumab. A 48-year-old man was admitted with a 3-week history of progressive visual loss of his left eye. He had received a second infusion of golimumab for ankylosing spondylitis 10 days before admission. A magnetic resonance imaging scan showed enhancement of both optic nerves and visual evoked potentials were consistent with demyelinating bilateral optic neuropathy, although visual acuity drop in the right eye could not be determined because of deep amblyopia. No improvement was observed after golimumab dechallenge or corticosteroid treatment. Demyelinating complications related to treatment with tumor necrosis factor alpha inhibitors (TNFAI) have been previously described. Golimumab, a fully human monoclonal antibody, is the most recently developed TNFAI and thus, fewer adverse effects have been reported. Further studies should be developed to elucidate if variability in golimumab's pharmacokinetics or TNF receptor binding affinity could explain different safety profiles compared with other TNFAI.

Departments of *Ophthalmology, †Neurology, and ‡Rheumatology, Donostia University Hospital, Spain.

Address correspondence and reprint requests to Marta de Frutos-Lezaun MD, Sagrada Familia St, 9-7-D. San Sebastian 20010, Spain; E-mail: mdefrutoslezaun@gmail.com

Conflicts of Interest and Source of Funding: The authors have no conflicts of interest to declare.

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