Long-Term Outcome of an Intravitreal Dexamethasone Implant for the Treatment of Noninfectious Uveitic Macular Edema

Abstract

Purpose: To report the long-term outcome of an intravitreal dexamethasone drug delivery system (DEX-DDS) injection for noninfectious uveitic macular edema. Methods: This was a retrospective study of 8 eyes (7 patients). Results: The mean follow-up time was 17.3 months. Macular edema resolved in all eyes at 3.9 weeks (range 1-6.9) postinjection. The central point thickness improved from 612 ± 143 to 250 ± 55 µm (p < 0.05). The mean best corrected visual acuity improved by 0.25 logMAR (p < 0.05) at 3.9 weeks (range 1-6.9) postinjection. In 5 eyes, macular edema did not recur after a mean follow-up of 14.5 months. In 3 eyes, macular edema relapsed after 4.7 months (range 3.6-6.3) and resolved again following further injections. Two eyes developed intraocular pressure elevation, which was well controlled with topical treatment. Conclusions: Intravitreal DEX-DDS injections resulted in resolution of macular edema and visual acuity improvement. Some eyes required repeated injections, but most eyes achieved long-term resolution. No significant complications were noticed.

Efficacy of Dexamethasone Implants in Uveitic Macular Edema in Cases with Behçet Disease

“…Unfortunately, conventional treatment and biologic agents were not comparable in this study due to inadequate intragroup sampling. Our results support the common data that the duration of dexamethasone implants is 4–6 months in vascular and uveitic macular edema cases; however, extended efficacy of the implant has been reported in some patients (i.e., up to 14.5 months)[7-9]. …”

“…Intravitreal dexamethasone implants represent an appealing option in cases where a bridging therapy is needed to save time, or in patients who are intolerant to biological agents. Long-term resolution of macular edema and improvement of visual acuity have been achieved with or without repeated injections of dexamethasone implants in inflammatory macula edema[7-9]. However, the data on the efficacy and safety in such cases are insufficient[10].…”

Dexamethasone Inserts in Noninfectious Uveitis

“…This saw-toothed effect on changes in the macula with photoreceptor alteration and even long-term toxicity of high steroid concentration may pose a risk to repeated treatment success. 11,12,16,17,19 It is tempting to speculate whether longer-acting devices containing DEX would be a more suitable solution.…”

Dexamethasone Implant in Pseudophakic and Nonglaucomatous Subgroup of Diabetic Macular Edema Patients: A Real Life Experience

“…While IDI was found to be effective in the treatment of macular edema secondary to vascular and inflammatory retinal diseases, it carried the potential risks of glucocorticosteroids, which are cataract formation and glaucoma (8-16). In this study, we aimed to evaluate the functional and anatomic outcomes of IDI in a theoretically ideal group of patients with DME who were pseudophakic, nonglaucomatous, and had no family history of glaucoma.…”