The Role of Dexamethasone Implant in the Management of Tubercular Uveitis

Ocul Immunol Inflamm. 2018;26(6):884-892. doi: 10.1080/09273948.2017.1400074. Epub 2017 Nov 30.

Abstract

Purpose: To study the safety and efficacy of intravitreal injection of dexamethasone implant in the management of posterior segment involvement in tubercular uveitis (TBU).

Methods: In this study, retrospective analysis of safety and efficacy of intravitreal injection of dexamethasone implant for various indications such as cystoid macular edema (CME), vitritis, or paradoxical worsening in TB-related intermediate uveitis, retinal vasculitis, and multifocal serpiginoid choroiditis (MSC) was performed.

Results: The study included 17 patients (19 eyes; 7 males). IOP increased from 14.88 ± 2.68 mm Hg to 16.4 ± 5.82 mm Hg (p = 0.18) at 3 months. BCVA improved from 0.37 ± 0.35 to 0.27 ± 0.21 at 3 months (p = 0.03). CME resolved at 3 months and two patients with paradoxical worsening showed resolution within 1 month.

Conclusion: Intravitreal dexamethasone implant is safe and efficacious as an adjunct to ATT in reducing the central macular thickness, vitritis, and progression of choroiditis lesions in paradoxical worsening of MSC.

Keywords: Cystoid Macular Edema; Dexamethasone Implant; Intraocular Tuberculosis; Ozurdex; Retinal Vasculitis; Serpiginous Choroiditis; TB.

MeSH terms

  • Adult
  • Dexamethasone / administration & dosage*
  • Drug Implants
  • Female
  • Glucocorticoids / administration & dosage
  • Humans
  • Intravitreal Injections
  • Male
  • Middle Aged
  • Retrospective Studies
  • Tomography, Optical Coherence
  • Treatment Outcome
  • Tuberculosis, Ocular / complications*
  • Tuberculosis, Ocular / drug therapy
  • Uveitis, Intermediate / diagnosis
  • Uveitis, Intermediate / drug therapy*
  • Uveitis, Intermediate / etiology
  • Visual Acuity*
  • Young Adult

Substances

  • Drug Implants
  • Glucocorticoids
  • Dexamethasone