Novel Intraocular Therapy in Non-infectious Uveitis of the Posterior Segment of the Eye

Abstract

This article reviews the new clinically relevant data regarding the intraocular treatment of non-infectious uveitis. Triamcinolone acetonide is the most commonly used intravitreal corticosteroid for treatment of uveitis and uveitic macular oedema. The drug is available at low cost but it is associated with a high risk of raised intraocular pressure (IOP) and cataract and is not licensed for intraocular use. Dexamethasone implant (Ozurdex®) appears to have a better safety profile, and a slightly long-lasting effect than triamcinolone acetonide. Fluocinolone acetonide implant (Retisert®) implant allows the release of corticosteroids at a constant rate over a 3-year period, but it requires surgical placement and its use is associated with a very high risk of cataracts and raised intraocular pressure. Iluvien® is another fluocinolone acetonide implant that could represent a more convenient treatment option for such cases in the future as it can be inserted into the vitreous cavity through 25-gauge injector system in an outpatient setting. To circumvent the risks associated with corticosteroids use, non-corticosteroids related therapeutics including intravitreal methotrexate; anti-vascular endothelial growth factor treatments and intravitreal sirolimus have been recently developed.

Keywords: Iluvien; Intraocular Therapy; Methotrexate; Non-infectious Uveitis; Ozurdex; Posterior Segment; Retisert; sirolimus.