[CIS PIDD] [cis-pidd] Eye disease in CVID

[CIS-PIDD]

In the GvH setting, we've used cyclosporine eye drops (restasis). There was a study on a CsA implant, but I don't think that that is commercially available (paper attached). If the ophthalmologist wants objective evidence of ocular autoimmunity prior to using restasis, he could do a meibomian gland biopsy. A number of meibographic techniques have been described as well, and the ophthalmologist might be familiar with that as a non-invasive alternative
-R


--
Rob Sokolic, MD
Medical Officer
Center for Biologics Evaluation and Research
Office of Tissues and Advanced Therapies
U.S. Food and Drug Administration
Tel: 240-402-5564
Robert.Sokolic at fda.hhs.gov<mailto:Robert.Sokolic at fda.hhs.gov>
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From: CIS-PIDD [mailto:cis-pidd at lists.clinimmsoc.org]
Sent: Wednesday, November 30, 2016 11:14 AM
To: CIS-PIDD
Subject: [cis-pidd] Eye disease in CVID

Dear colleagues,

We have a 55-yo white female with CVID, who has suffered from severe bilateral blepharitis, episcleritis, and dry eye for 2 years now to the point that she has lost all eyelashes. So far there is no evidence of uveitis or retinal diseases. No improvement from steroids eye drops or oral.

Her ophthalmologist is at a loss in how to proceed. I was wondering if her eyelid and scleral diseases are related to CVID. She is otherwise doing well from infection standpoint, IgG levels >1,000 on IVIG, IgA 10s, and IgM 20-30s. She does not have dry mouth, autoimmune manifestations, or lymphoid infiltrations. Her T, B cell counts and their subsets are normal.

Does anyone have experience with CVID patients like this? I would appreciate comments or suggestions. I looked up the literature and most reports of eye diseases in CVID are more of uveitis or retinal diseases, similar to those seen in sarcoidosis.

Thank you,
Panida

Panida Sriaroon, MD
Associate Professor
Associate Director, Fellowship Program
Medical Director, USF/All Children's Hospital Allergy/Immunology clinic
E-mail  psriaroo at health.usf.edu<mailto:psriaroo at health.usf.edu>



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