PURPOSE: We report our experience in treating 2 patients of idiopathic retinal 
vasculitis, aneurysm, and neuroretinitis (IRVAN) syndrome with antitumor 
necrosis factor agent, infliximab, who showed a very favorable response to 
treatment.
METHODS: Two patients with clinical diagnosis of IRVAN syndrome were included in 
the study. The visual acuity was affected due to ocular inflammation and 
presence of macular edema due to exudation around the optic nerve.
RESULTS: The patients did not respond to initial treatment with oral steroids, 
and visual acuity continued to deteriorate due to macular exudation. Infliximab 
therapy resulted in prompt resolution of the inflammatory reaction and retinal 
exudation, with improvement in visual acuity, that was subsequently maintained 
with maintenance therapy. The intravenous infliximab infusions were scheduled at 
0, 4, 8, and 12 weeks initially, and every 2 months thereafter. Retinal 
neovasculariztion in each patient was managed by pan retinal photocoagulation.
CONCLUSION: Infliximab therapy may be useful in reducing inflammation and 
leakage from the optic nerve in patients with IRVAN syndrome. This may help 
preserve or improve visual acuity. However, further studies are required to 
evaluate the long-term benefits of this therapy.