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Observational Study
. 2021 Mar 1;41(3):620-629.
doi: 10.1097/IAE.0000000000002901.

UVEITIS TREATED WITH DEXAMETHASONE IMPLANT

Thibaud Mathis  1   2 , Alessio Cerquaglia  3   4 , Michel Weber  5 , Rébecca Guillarme-Sallit  1 , Ariane Malclès  1 , Nicolas Voirin  6 , Marion Servant  5 , Aditya Sudhalkar  7   8 , Alper Bilgic  7 , Philippe Denis  1 , Pascal Sève  9 , Bahram Bodaghi  3 , Laurent Kodjikian  1   2
Affiliations
Observational Study

UVEITIS TREATED WITH DEXAMETHASONE IMPLANT

Thibaud Mathis et al. Retina. .

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.

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Conflict of interest statement

T. Mathis declared conflicts of interest from Allergan, Bayer, and Novartis; M. Weber declared conflicts of interest from Allergan; P. Denis declared conflicts of interest from Allergan and Novartis; B. Bodaghi declared conflicts of interest from AbbVie, Allergan, Alimera, and Santen; L. Kodjikian declared conflicts of interest from AbbVie, Allergan, Bayer, Novartis, Roche, and Théa. None of the other authors has any financial interests to disclose.

References

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    1. Multicenter Uveitis Steroid Treatment (MUST) Trial Research Group, Kempen JH, Kempen JH, Altaweel MM, et al. Randomized comparison of systemic anti-inflammatory therapy versus fluocinolone acetonide implant for intermediate, posterior, and panuveitis: the multicenter uveitis steroid treatment trial. Ophthalmology 2011;118:1916–1926.
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    1. Goldstein DA, Godfrey DG, Hall A, et al. Intraocular pressure in patients with uveitis treated with fluocinolone acetonide implants. Arch Ophthalmol 2007;125:1478–1485.

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