Treatment of noninfectious posterior uveitis with dexamethasone intravitreal implant

Abstract

PurposeTo report our experience with dexamethasone 0.7 mg sustained-release intravitreal implant (Ozurdex®; Allergan, Inc, Irvine, CA) in noninfectious posterior uveitis.MethodsA retrospective chart review of patients with noninfectious uveitis treated with sustained-release dexamethasone 0.7 mg intravitreal implant was performed. Complete ophthalmic examination including signs of inflammatory activity, visual acuity, fundus photography, fluorescein angiography, optical coherence tomography, and tolerability of the implant were assessed.ResultsSix eyes of 4 consecutive patients treated with a total of 8 dexamethasone 0.7 mg sustained-release intravitreal implants for posterior noninfectious uveitis were included. Two patients presented with unilateral idiopathic posterior uveitis; 2 patients had bilateral posterior uveitis, one secondary to sarcoidosis and the other to Vogt-Koyanagi-Harada syndrome. All eyes showed clinical and angiographic evidence of decreased inflammation following implant placement. Mean follow-up time post-injection was 5.25 months. Four eyes received 1 and 2 eyes received 2 Ozurdex implants during the follow-up period. The duration of effect of the implant was 3 to 4 months. No serious ocular or systemic adverse events were noted during the follow-up period.ConclusionsIn patients with noninfectious posterior uveitis, sustained-release dexamethasone 0.7 mg intravitreal implant may be an effective treatment option for controlling intraocular inflammation.

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

“…Myung et al [20] and Miserocchi et al [21] also did not find formation or progression of cataracts at 5 and 9 months of follow-up, respectively.…”

“…Two small short-term retrospective case-series on dexamethasone implant treatment for noninfectious posterior uveitis have been published to date [20,21]. …”

“…The first study, by Myung et al [20], had a mean follow-up of 5.25 months. In their series, only 2 eyes (2 patients) had CME which resolved after dexamethasone injection but recurred 4 months after the injection.…”

“…In the series of Myung et al [20], none of the eyes showed an increase in IOP. However, in the series of Miserocchi et al [21], 3 eyes (25%) had an increase in IOP of less than 30 mm Hg 2 weeks after dexamethasone implant injection, which was controlled with topical antiglaucoma treatment.…”

“…Two small retrospective case series on intravitreal 0.7-mg DEX-DDS injection for noninfectious posterior uveitis have been published to date, and they reported a good treatment effect on macular edema with a safe profile in a short-term follow-up [20,21]. A recent study showed favorable short-term visual outcomes in vitrectomized eyes with persistent uveitic CME [22].…”