1. 12/9/2018
CLINICAL CASE:
69 year-old female with rheumatoid arthritis diagnosed 30 years ago
No ocular symptoms before
Relapse episodes of pain, inflammation and stiffnes in peripheral joints
Etanercept (February 2012)

2. CLINICAL CASE: First acute episode (November-2012)
Ocular reddening and pain in OD. No articular symotoms.
BCVA: 0,5 OD // 0,8 OI
BMC OD: Tyndall +++, Posterior synechia 360º, Keratic precipitates
Fundus: No abnormalities. IOP: 12//18
Firts episode of anterior uveitis!Treatment: Corticosteroids + Mydriatics

3. In 2 years of monitoring….
2 relapse episodes despite Etanercept
Switch Etanercept to Golimumab (November 2013)
Deterioration of articular symptoms
Reintroduce Etanercept (August 2014)
New episode of Uveitis!
Switch Etanercept to Infliximab (November 2014)

4. CURRENTLY: In last visit (November 205)
Infliximab monotherapy
Clincal stability: No new relapse episodes of uveitis
No articular sintoms.
Subjectively ok

5. CONCLUSION:
In rheumatoid arthritis, Etanercept can cause paradoxical uveitis even if it controls articular symptoms.
In these cases we can consider different biological agents
Even in monotherapy, Infliximab may be a good therapeutic tool to control ocular and articular symptoms in these kind of patients.