Claudia Fabiani1, Antonio Vitale2, Giacomo Emmi3, Giuseppe Lopalco4, Lorenzo Vannozzi5, Daniela Bacherini5, Silvana Guerriero6, Rosa Anna Favale6, Fiorella Fusco7, Rossella Franceschini7, Bruno Frediani2, Florenzo Iannone4, Mauro Galeazzi2, Gian Marco Tosi7, Luca Cantarini2. 1. 1 Department of Ophthalmology, Humanitas Clinical and Research Center , Milan, Italy . 2. 2 Research Center of Systemic Autoinflammatory Diseases and Behçet's Disease and Rheumatology-Ophthalmology Collaborative Uveitis Center, Department of Medical Sciences, Surgery and Neurosciences, University of Siena , Siena, Italy . 3. 3 Department of Experimental and Clinical Medicine, University of Florence , Florence, Italy . 4. 4 Department of Emergency and Organ Transplantation, Rheumatology Unit, Bari, Italy . 5. 5 Department of Surgery and Translational Medicine, Eye Clinic, University of Florence , Florence, Italy . 6. 6 Department of Ophthalmology and Otolaryngology, Bari University , Bari, Italy . 7. 7 Ophthalmology Unit of the Department of Medicine, Surgery and Neuroscience, University of Siena , Siena, Italy .
Abstract
PURPOSE: To evaluate the effectiveness and the systemic corticosteroid sparing effect of a single intravitreal dexamethasone (DEX) implant in patients with chronic noninfectious uveitic macular edema (UME). METHODS: Data from 22 eyes treated with DEX implant for UME related to systemic or ocular-confined noninfectious diseases were retrospectively analyzed. RESULTS: The mean systemic prednisone (or equivalent) dosage significantly decreased at 3- and 6-month follow-up evaluations compared to baseline (P = 0.002 and P = 0.01, respectively). Compared to baseline, central macular thickness values significantly decreased at 1-, 3-, and 6-month evaluations after the implantation (P < 0.0001). The mean best corrected visual acuity (BCVA) value gradually improved at 1-, 3-, and 6-month visits compared to baseline (P = 0.009, P = 0.0004, and P = 0.0001, respectively). At fluorescein angiography, active retinal vasculitis was identified in 11 (50%) eyes at baseline, 3 (13.6%) eyes at 1- and 3-month follow-up, and in 2 (9.1%) eyes at the last visit. Regarding side effects, 3/22 (13.6%) eyes presented a newly recognized intraocular hypertension at 1-month follow-up; however, intraocular pressure reverted to normal values within the 6-month follow-up in all cases. CONCLUSIONS: Treatment with intravitreal DEX implant in noninfectious uveitis allowed a significant corticosteroid sparing effect, a significant improvement in BCVA, and a prompt resolution of UME and vasculitis. No safety issues were observed.
PURPOSE: To evaluate the effectiveness and the systemic corticosteroid sparing effect of a single intravitreal dexamethasone (DEX) implant in patients with chronic noninfectious uveitic macular edema (UME). METHODS: Data from 22 eyes treated with DEX implant for UME related to systemic or ocular-confined noninfectious diseases were retrospectively analyzed. RESULTS: The mean systemic prednisone (or equivalent) dosage significantly decreased at 3- and 6-month follow-up evaluations compared to baseline (P = 0.002 and P = 0.01, respectively). Compared to baseline, central macular thickness values significantly decreased at 1-, 3-, and 6-month evaluations after the implantation (P < 0.0001). The mean best corrected visual acuity (BCVA) value gradually improved at 1-, 3-, and 6-month visits compared to baseline (P = 0.009, P = 0.0004, and P = 0.0001, respectively). At fluorescein angiography, active retinal vasculitis was identified in 11 (50%) eyes at baseline, 3 (13.6%) eyes at 1- and 3-month follow-up, and in 2 (9.1%) eyes at the last visit. Regarding side effects, 3/22 (13.6%) eyes presented a newly recognized intraocular hypertension at 1-month follow-up; however, intraocular pressure reverted to normal values within the 6-month follow-up in all cases. CONCLUSIONS: Treatment with intravitreal DEX implant in noninfectious uveitis allowed a significant corticosteroid sparing effect, a significant improvement in BCVA, and a prompt resolution of UME and vasculitis. No safety issues were observed.
Authors: Murat Hasanreisoğlu; Hüseyin Baran Özdemir; Kaan Özkan; Murat Yüksel; Zeynep Aktaş; Hatice Tuba Atalay; Şengül Özdek; Gökhan Gürelik Journal: Turk J Ophthalmol Date: 2019-10-24