Adalimumab for treatment of idiopathic frosted branch angiitis: a case report

To report a case of recurrent idiopathic frosted branch angiitis (FBA) successfully treated with adalimumab. A 14-year-old otherwise healthy boy was referred to the uveitis clinic for bilateral panuveitis with diffuse retinal vascular sheathing and severe macular edema. Extensive work-up including aqueous sampling for detection of viral causes was inconclusive. Two years ago, a similar episode had been treated with oral prednisolone, however it was complicated by adverse psychiatric effects. The progressive course of the condition mandated considering other therapeutic measures; Adalimumab was chosen based on its purported efficacy for treatment of childhood uveitis and a favorable safety profile. The patient responded dramatically to a single subcutaneous injection of adalimumab without any side effect during and after injection. The therapeutic effect was rapid and relatively long-lasting. To the best of our knowledge, this is the first case of idiopathic FBA treated successfully with adalimumab without adjunctive steroid therapy.