Peer Review manuscript Ms_AJRROP_107125: Retrobulbar optic neuritis associated with certolizumab

Abstract

Aims: to report a case of retrobulbar optic neuritis (ON) associated with certolizumab. Case report: A 22-year-old man presented with a 4 days history of decreased vision in the left eye accompanied by pain on extraocular movement. He had received an infusion of certolizumab for juvenile idiopathic arthritis 3 weeks before symtomatology. Ocular examination of the left eye revealed a left afferent pupillary defect. The best-corrected visual acuity was 1/10. Anterior segment and fundoscopy were normal. Visual evoked potentials a prolonged latency of the P100 in the left eye. Diagnosis of certolizumab-induced retrobulbar ON was made. Certolizumab was discontinued and the patient was treated with corticosteroids with good visual outcome. Discussion: Occurrence of ON during treatment with anti-tumor necrosis factor α was reported in the literature, mainly with etanercept, then infliximab and adalimumab. There are few cases of ON associated with certolizumab. Conclusion: This case illustrates the possibility of ON during treatment with certolizumab. Careful monitoring of patients receiving this therapy is necessary to identify ophthalmological or neurological side effects.