Uveitis Treated With Dexamethasone Implant

Abstract

Purpose: To evaluate the real-life efficacy and safety of the intravitreal dexamethasone implant in uveitis. Methods: This retrospective observational multicentric study included 152 eyes treated exclusively by 358 dexamethasone implant injections. The main outcome measures included change in the best-corrected visual acuity, central macular thickness, and vitreous haze score. Results: Patients were treated with dexamethasone implant for macular edema (51.3%), vitritis with macular edema (40.1%), vitritis (5.3%), and other causes (3.3%). The mean duration of follow-up was 19.0 months. The mean gain in best-corrected visual acuity during follow-up was +12.1 letters. An improvement in best-corrected visual acuity ≥5, 10, and 15 letters was found in 64.5, 50.7, and 35.5% of cases, respectively. 59.7% of eyes with macular edema at baseline were found to be anatomical responders. Vitritis resolution (vitreous haze = 0+) was obtained in 81.4% of cases. Ocular hypertension (intraocular pressure ≥25 mmHg and/or gain ≥10 mmHg from baseline) occurred in 28.3% of patients. No filtering surgery/laser therapy was required. A total of 40.2% of phakic subjects underwent cataract surgery on average 11.2 months after the first injection. Conclusion: This study confirms the efficacy and safety of the dexamethasone implant in noninfectious uveitis. Cataract and ocular hypertension were not uncommon but easily manageable.

Real-Life Efficacy, Safety, and Use of Dexamethasone Intravitreal Implant in Posterior Segment Inflammation Due to Non-infectious Uveitis (LOUVRE 2 Study)

“…The safety and efficacy findings of the LOUVRE 2 study are further reinforced by similar findings from retrospective studies of DEX in uveitis in real-word clinical practice [22][23][24][25]. Of those, the recently published RUVDEX study [24] was conducted at three centers in France and evaluated outcomes in 152 eyes with noninfectious uveitis that were treated with DEX (total of 358 implants) and followed for a mean of 19 months.…”

“…The safety and efficacy findings of the LOUVRE 2 study are further reinforced by similar findings from retrospective studies of DEX in uveitis in real-word clinical practice [22][23][24][25]. Of those, the recently published RUVDEX study [24] was conducted at three centers in France and evaluated outcomes in 152 eyes with noninfectious uveitis that were treated with DEX (total of 358 implants) and followed for a mean of 19 months. In the RUVDEX study, although only 23.7% of the eyes studied had posterior uveitis, all treated eyes demonstrated substantial improvements in BCVA from a baseline mean of 60.1 letters, with mean gains of 5.3, 6.2, 4.2, 4.8, and 4.4 letters at months 2, 4, 6, 12, and 24, respectively [19].…”

“…Moreover, 81.4% of patients had a vitreous haze score of 0 during follow-up, compared with a median value of 0.5 at baseline. Although cataract and ocular hypertension were reported following DEX treatment, both AEs were manageable [24].…”

Case report: Ultrasound biomicroscopy as a guide for the selection of injection sites for dexamethasone intravitreal implant (Ozurdex) for peripheral granulomatous ocular toxocariasis in children

“…(1) Increased intraocular pressure (IOP) post-injection: DEX injection can cause ocular hypertension (OHT) (IOP ≥ 25 mmHg and/or an increase of ≥10 mmHg compared to baseline), which is attributable to the DEX implant itself. However, IOP can be controlled in the short term with the use of some topical IOP-lowering medications ( 33 , 36 – 38 ). In our case, the patient experienced elevated IOP after injection, but it returned to pre-injection levels after the use of IOP-lowering eye drops.…”

Combined central retinal artery and vein occlusion associated with primary antiphospholipid syndrome treated by injection of dexamethasone intravitreal implant and anticoagulant therapy: a case report

“…More recently, anti-vascular endothelial growth factor (VEGF) therapies have been introduced as an acceptable alternative to alleviate ocular symptoms [7] . Since various factors are involved in its pathogenesis, among which inflammation plays an important role, we believe that Ozurdex, an approved dexamethasone intravitreal implant, might be more effective in alleviating macular edema and improving visual acuity based on its anti-inflammatory mechanism, which is key in initiating procoagulant activity [8] . In summary, we present a case of combined CRAO and CRVO in a patient with primary APS.…”