Safety and Efficacy of Intravitreal Dexamethasone Implants in the Management of Macular Edema Secondary to Infectious Uveitis

Fonollosa, Alex; Llorenç, Víctor; Artaraz, Joseba; Jiménez, Beatriz; Ruiz-Arruza, Ioana; Agirrebengoa, Koldo; Cordero‐Coma, Miguel; Costales-Mier, Felipe; Adán, Alfredo

doi:10.1097/iae.0000000000001001

Cited by 25 publications

(18 citation statements)

References 15 publications

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“…In contrast, a small series of seven patients demonstrated safety of DII in treating CMO in patients with infectious uveitis where other treatments for CMO had failed. All patients were concurrently treated on the appropriate antimicrobial agent and had resolution of CMO without reactivation of the infectious ocular disease …”

Section: Complications Of Ocular and Periocular Steroid Deliverymentioning

confidence: 99%

Local delivery of corticosteroids in clinical ophthalmology: A review

Fung

Tran

Lim

et al. 2020

Clinical Exper Ophthalmology

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Locally administered steroids have a long history in ophthalmology for the treatment of inflammatory conditions. Anterior segment conditions tend to be treated with topical steroids whilst posterior segment conditions generally require periocular, intravitreal or systemic administration for penetration. Over recent decades, the clinical applications of periocular steroid delivery have expanded to a wide range of conditions including macular oedema from retino-vascular conditions. Formulations have been developed with the aim to provide practical, targeted, longer-term and more efficacious therapy whilst minimizing side effects. Herein, we provide a comprehensive overview of the

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Section: Complications Of Ocular and Periocular Steroid Deliverymentioning

confidence: 99%

Local delivery of corticosteroids in clinical ophthalmology: A review

Fung

Tran

Lim

et al. 2020

Clinical Exper Ophthalmology

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“…To our knowledge there is only one case report in the literature where dexamethasone implant was used as adjuvant treatment for CME secondary to syphilitic uveitis [ 3 ]. However, only one implant was required in that case and there was no documentation of RPR titers showing that reinfection had been excluded prior to intravitreal steroid treatment [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

“…The use of intravitreal corticosteroids in the treatment of syphilis-related uveitis, however, is sparsely documented, due to clinical concern of syphilis reactivation after corticosteroid injection [ 3 ]. This concern mainly arises due to several reports that describe the unmasking or worsening of untreated ocular syphilis after intravitreal triamcinolone acetonide injection for what was presumed to be noninfectious, uveitis-related cystoid macular edema (CME) [ 4 – 6 ].…”

Section: Introductionmentioning

confidence: 99%

Repeat Intravitreal Dexamethasone Implant for Refractory Cystoid Macular Edema in Syphilitic Uveitis

Lautredou

Hardin

Chancellor

et al. 2018

Case Reports in Ophthalmological Medicine

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Purpose To report the successful utilization of adjunctive repeat intravitreal corticosteroid therapy for the treatment of cystoid macular edema in syphilis-related uveitis. Methods/Patients An HIV-positive patient with treated ocular syphilis who developed refractory cystoid macular edema (CME) was treated with repeat intravitreal corticosteroid therapy including dexamethasone intravitreal implants. Results Treatment led to the resolution of CME and improvement in visual acuity. Conclusions Intravitreal corticosteroid therapy may be a viable adjunctive treatment for refractory CME in patients with treated syphilitic uveitis. Corticosteroid-induced exacerbation of infection is unlikely in patients with an adequate serologic treatment response.

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“…The intravitreal DEX implant has been successfully employed in patients with infectious uveitis, though the presence of intraocular infection represents a formal contraindication (Table 3) [118][119][120][121][122][123]. Intravitreal Dex should not be advocated as a primary treatment option in patients with infectious uveitis, however it could represent a useful and minimally invasive therapeutic resource in carefully selected cases.…”

Section: Evidence Of the Efficacy Of Dex In Other Conditionsmentioning

confidence: 99%

Section: Dex Implant In Other Conditionsmentioning

confidence: 99%

Intravitreal Dexamethasone Implant as a Sustained Release Drug Delivery Device for the Treatment of Ocular Diseases: A Comprehensive Review of the Literature

et al. 2020

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Drug delivery into the vitreous chamber remains a great challenge in the pharmaceutical industry due to the complex anatomy and physiology of the eye. Intravitreal injection is the mainstream route of drug administration to the posterior segment of the eye. The purpose of this review is to assess the current literature about the widening use of the intravitreal 0.7 mg dexamethasone (Dex) implant, and to provide a comprehensive collection of all the ocular disorders that benefit from Dex administration. Although anti-vascular endothelial growth-factors (VEGFs) have been largely indicated as a first-choice level, the Dex implant represents an important treatment option, especially in selected cases, such as vitrectomized eyes or patients in whom anti-VEGF failed or are contraindicated. In this article, the safety profile as well as the list of the possible complications related to intravitreal Dex injection are also discussed.

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Safety and Efficacy of Intravitreal Dexamethasone Implants in the Management of Macular Edema Secondary to Infectious Uveitis

Cited by 25 publications

References 15 publications

Local delivery of corticosteroids in clinical ophthalmology: A review

Local delivery of corticosteroids in clinical ophthalmology: A review

Repeat Intravitreal Dexamethasone Implant for Refractory Cystoid Macular Edema in Syphilitic Uveitis

Intravitreal Dexamethasone Implant as a Sustained Release Drug Delivery Device for the Treatment of Ocular Diseases: A Comprehensive Review of the Literature

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