Response to telitacicept in optic neuritis associated with Sjogren's syndrome: a case report and literature review

Area of Science:

• Ophthalmology
• Neurology
• Rheumatology

Background:

• Optic neuritis (ON) is an early sign of multiple sclerosis and neuromyelitis optica.
• ON can also manifest as central nervous system damage in Sjögren's syndrome (SS).
• Research on SS-associated ON is limited, lacking standard treatments and having high recurrence rates.

Observation:

• A 54-year-old female presented with dry eyes, dry mouth, and vision loss.
• Positive autoantibodies (anti-SSA/Ro and anti-SSB/La) and salivary gland biopsy confirmed SS.
• Visual evoked potentials showed absent waveforms in the left eye, diagnosing SS-associated ON.

Findings:

• Conventional treatments (glucocorticoids and cyclophosphamide) were ineffective.
• Telitacicept, combined with minimal glucocorticoid dosage, led to significant improvement in vision and dryness.
• A 9-month follow-up revealed no recurrence or adverse effects, indicating good efficacy and safety.

Implications:

• SS-associated ON is uncommon and prone to misdiagnosis.
• Standard ON treatments often fail to prevent recurrence in SS patients.
• Telitacicept emerges as a potentially effective and safe therapeutic option for SS-associated ON.