[Efficacy of a Dexamethasone Implant for the Treatment of Refractory Cystoid Macular Oedema in Non-Infectious Uveitis]

Klin Monbl Augenheilkd. 2016 May;233(5):601-5. doi: 10.1055/s-0042-102058. Epub 2016 May 17.
[Article in German]

Abstract

Purpose: To evaluate the efficacy of an intravitreal dexamethasone implant (Ozurdex®) in patients with cystoid macular oedema (CME) suffering from non-infectious uveitis.

Methods: Monocentric, retrospective, single-arm analysis in 49 patients (59 implanted eyes) with inactive uveitis, in whom CME had been unresponsive to corticosteroids and/or immunosuppressants and systemic acetazolamide, and who received a dexamethasone implant. Patients were followed up at 6, 12 and 24 weeks after unilateral (n = 39)/bilateral (n = 10) implantation. The primary outcome measure was central foveal thickness (CFT), as measured by Spectralis optical coherence tomography (OCT); secondary outcome measures were improvement in best-corrected visual acuity (BCVA), laser flare photometry and safety measures, including intraocular pressure (IOP) and cataract progression.

Results: At 6, 12 and 24 weeks, mean CFT was reduced (≥ 20 %) in 68, 44 and 45 % and BCVA improved (≥ 2 lines) in 47, 40 and 26 %, respectively, as compared to baseline. At 6, 12 and 24 weeks, significant flare reduction was observed in 70, 41, and 42 %, respectively. Cumulative cataract progression was observed in 12, 18 and 31 % at 6, 12 and 24 weeks, respectively. IOP ≥ 22 mmHg was noted in 5 % at baseline and in 21, 3, and 0 % at 6, 12 and 24 weeks, respectively.

Conclusions: In uveitis patients with CME refractory to systemic anti-inflammatory drugs, the dexamethasone implant improves CME transiently. However, IOP increase and cataract progression are common side effects.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Inflammatory Agents / administration & dosage
  • Chronic Disease
  • Dexamethasone / administration & dosage*
  • Drug Implants / administration & dosage*
  • Female
  • Humans
  • Intravitreal Injections
  • Macular Edema / diagnosis
  • Macular Edema / drug therapy*
  • Macular Edema / etiology
  • Male
  • Middle Aged
  • Retrospective Studies
  • Treatment Outcome
  • Uveitis / complications
  • Uveitis / diagnosis
  • Uveitis / drug therapy*
  • Vision Disorders / diagnosis
  • Vision Disorders / etiology
  • Vision Disorders / prevention & control*
  • Visual Acuity / drug effects
  • Young Adult

Substances

  • Anti-Inflammatory Agents
  • Drug Implants
  • Dexamethasone