Systemic Steroid Sparing Effect of Intravitreal Dexamethasone Implant in Chronic Noninfectious Uveitic Macular Edema.

Abstract

PURPOSE:

To evaluate the effectiveness and the systemic corticosteroid sparing effect of a single intravitreal dexamethasone (DEX) implant in patients with chronic noninfectious uveitic macular edema (UME).

METHODS:

Data from 22 eyes treated with DEX implant for UME related to systemic or ocular-confined noninfectious diseases were retrospectively analyzed.

RESULTS:

The mean systemic prednisone (or equivalent) dosage significantly decreased at 3- and 6-month follow-up evaluations compared to baseline (P = 0.002 and P = 0.01, respectively). Compared to baseline, central macular thickness values significantly decreased at 1-, 3-, and 6-month evaluations after the implantation (P < 0.0001). The mean best corrected visual acuity (BCVA) value gradually improved at 1-, 3-, and 6-month visits compared to baseline (P = 0.009, P = 0.0004, and P = 0.0001, respectively). At fluorescein angiography, active retinal vasculitis was identified in 11 (50%) eyes at baseline, 3 (13.6%) eyes at 1- and 3-month follow-up, and in 2 (9.1%) eyes at the last visit. Regarding side effects, 3/22 (13.6%) eyes presented a newly recognized intraocular hypertension at 1-month follow-up; however, intraocular pressure reverted to normal values within the 6-month follow-up in all cases.

CONCLUSIONS:

Treatment with intravitreal DEX implant in noninfectious uveitis allowed a significant corticosteroid sparing effect, a significant improvement in BCVA, and a prompt resolution of UME and vasculitis. No safety issues were observed.

• Authors: Claudia Fabiani, Antonio Vitale, Giacomo Emmi, Giuseppe Lopalco, Lorenzo Vannozzi, Daniela Bacherini, Silvana Guerriero, Rosa Anna Favale, Fiorella Fusco, Rossella Franceschini, Bruno Frediani, Florenzo Iannone, Mauro Galeazzi, Gian Marco Tosi, Luca Cantarini
• Journal: Journal of ocular pharmacology and therapeutics : the official journal of the Association for Ocular Pharmacology and Therapeutics (J Ocul Pharmacol Ther) Vol. 33 Issue 7 Pg. 549-555 (09 2017) ISSN: 1557-7732 [Electronic] United States
• PMID: 28557602 (Publication Type: Journal Article)

Chemical References

• Drug Implants
• Glucocorticoids
• Dexamethasone
• Prednisone

Topics

• Chronic Disease
• Dexamethasone (administration & dosage)
• Drug Implants
• Female
• Fluorescein Angiography
• Glucocorticoids (administration & dosage)
• Humans
• Intraocular Pressure (drug effects)
• Intravitreal Injections
• Macular Edema (drug therapy, physiopathology)
• Male
• Middle Aged
• Prednisone (administration & dosage)
• Retrospective Studies
• Tomography, Optical Coherence
• Treatment Outcome
• Uveitis (drug therapy, physiopathology)
• Visual Acuity (drug effects)