Volume 9 Supplement 2

6th European Workshop on Immune-Mediated Inflammatory Diseases

Open Access

Case series: rituximab in the treatment of refractory sight-threatening scleritis

  • Kiki van Bilsen1,
  • P Martin van Hagen1,
  • Tom Missotten3,
  • Seerp G Baarsma3,
  • Robert W Kuijpers2 and
  • Jan AM van Laar1
Journal of Translational Medicine20119(Suppl 2):P12


Published: 23 November 2011


Scleritis is a chronic vasculitis of scleral vessels leading to a substantial amount of morbidity and even blindness. Oral steroids and intensive immunosuppressive treatments are often used to to achieve long-term control of disease. But those drugs have severe adverse effects and there is a significant number of non-responders. We describe six patients with refractory scleritis who received rituximab.


A case series of six patients (aged 39-66) with refractory scleritis (4 idiopathic, 2 relapsing polychondritis), including B cell monitoring. One treatment cycle consisted of 1000 mg initially and 1000 mg two week later. Prior to infusion 100 mg methyprednisolon was administered i.v.


In all patients disease activity decreased. However, in four patients symptoms returned resp. 2,4,6 and 9 months after therapy. In two cases complete remission was achieved. Two patients received a second rituximab cycle successfully. No correlation was found between B cells reoccurrence and refractory disease. [Figure 1]

Figure 1


Clinical activity of scleritis in all patients decreased after treatment. In two cases scleritis went in complete remission after one cycle of treatment. Rituximab may be a new promising therapeutic tool in the treatment of refractory scleritis. There is no correlation between relapses and B cell recovery.

Authors’ Affiliations

Dept. of Internal Medicine/Clinical Immunology, Erasmus University Medical Center
Dept of Opthalmology, Erasmus University Medical Center
The Rotterdam Eye Hospital


© van Bilsen et al; licensee BioMed Central Ltd. 2011

This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.