Macular edema (ME) may complicate anterior,

The dexamethasone intravitreal implant can be safely used to treat ME due to non-infectious uveitis, but with a limited and short effect on BCVA.

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Purpose To evaluate the diagnostic and prognostic values of lumbar puncture in Vogt‐Koyanagi‐Harada (VKH) syndrome. Methods Medical records of patients seen in a single tertiary center between 1995 and 2013, with confirmed VKH syndrome according to the Revised Diagnostic Criterias, were retrospectively reviewed. Clinical stage of the disease, cerebrospinal fluid (CSF) analysis, therapeutic strategy, and prognosis were compared. Results 68 patients with a confirmed diagnosis of VKH disease were initially reviewed. Among them, 29 patients (42%) had undergone a lumbar puncture (LP). 21 LP (72.4%) were performed at the early stage of the disease, and 11 were performed at the chronic stage of the disease (37.6%). 16 patients (55%) had a pleiocytosis. LP was abnormal in 66,7% at the acute phase and 27% at the chronic phase. An average of 62.3 lymphocytes /mm3 was observed when LP was performed during the acute phase and an average of 9.5 lymphocytes / mm3 was observed during the chronic phase ( p = 0,03). For two cases, the patient met the diagnostic criteria because of the LP findings. Patients dependant on low doses of steroids (<5mg/d) had more lymphocytes (93,8 lymphocytesmm3) into the initial CSF analysis compared to the patients dependant on high doses of steroids (>5mg/d) ( 29,3 lymphocytesmm3) (p=0.03) when LP was performed at the acute phase of the disease. Conclusion The number of lymphocytes in the CSF at the diagnostic phase seems to be one of the prognostic factors for the outcome of VKH. Patients with a low pleiocytosis in the initial lumbar puncture should be closely monitored and may require a more aggressive treatment. Those conclusions must be confirmed with a prospective study.

Purpose To evaluate efficacy and safety of dexamethasone implant in patients with non infectious uveitis. Methods Retrospective study. Charts of 30 patients with non infectious uveitis treated with dexamethasone implant between September 2012 from April 2013 were reviewed. Best corrected visual acuity (BCVA), intra‐ocular pressure (IOP), laser flare meter and retinal central mean thickness (CMT) were followed up initially, at 1 and 3 months in each patient. Results 29 patients of 30 were treated for a macular edema. 1 patient was treated to improve the anti‐inflammatory control for a Behçet disease refractory to immunosupressive therapy. Intravitreal dexamethasone injection was effective in improving BCVA : preoperative mean BCVA was 0.57 logMAR units and improved to 0.45 and 0.43 logMAR units at month 1 and 3. Mean CMT also improved in all patients : the pre‐operative mean CMT was 455 μm and improved to 300 and 312 μm at months 1 and 3, respectively. Macular edema began to relapse in 23 patients at 3 months. Mean anterior chamber flare measured by laser decreased from 250 photons/ms to 60 photons/ms. Safety was good with 3 cases of IOP increase resolved by medical treatment only, 1 case of intravitreal hemorrhage treated by vitrectomy. Conclusion OZURDEX(®) appeared effective in management of uveitis macular edema but its action was short with frequent relapse at 3 months. Its safety seemed to be good. Further studies are needed to evaluate its place in the treatment strategy.