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Am J Ophthalmol. 2014 Dec;158(6):1136-1145.e5. doi: 10.1016/j.ajo.2014.09.003. Epub 2014 Sep 8.

Multicenter study of intravitreal dexamethasone implant in noninfectious uveitis: indications, outcomes, and reinjection frequency.

Author information

1
Bristol Eye Hospital, Bristol, United Kingdom; Gloucestershire Hospitals National Health Service Trust, Cheltenham, United Kingdom; Institut Clínic d'Oftalmologia (ICOF), Hospital Clínic, Barcelona, Spain. Electronic address: jzarranz@hotmail.com.
2
Bristol Eye Hospital, Bristol, United Kingdom.
3
Gloucestershire Hospitals National Health Service Trust, Cheltenham, United Kingdom.
4
Hospital Universitario de Cruces, Bilbao, Spain.
5
Institut Clínic d'Oftalmologia (ICOF), Hospital Clínic, Barcelona, Spain.
6
Bristol Eye Hospital, Bristol, United Kingdom; National Institute for Health Research Biomedical Research Centre at Moorfields Eye Hospital National Health Service Foundation Trust and University College London Institute of Ophthalmology, London, United Kingdom; University Hospitals Bristol National Health Service, Foundation Trust, and University of Bristol, Bristol, United Kingdom.

Abstract

PURPOSE:

To identify clinical outcomes and treatment patterns of intravitreal dexamethasone implant (Ozurdex; Allergan, Inc) in noninfectious uveitis in the clinical setting.

DESIGN:

Multicenter retrospective cohort study.

METHODS:

Eighty-two eyes (63 patients) receiving 142 implant injections over 35 months were included. Treatment indication, uveitis diagnosis, visual acuity, intraocular pressure, vitreous haze score, central retinal thickness by optical coherence tomography, phakic status, number of injections, time to reinjection, systemic treatments, and complications data were collected. Time to visual acuity and vitreous haze score improvement as per the Standardization of Uveitis Nomenclature guidelines were also determined.

RESULTS:

The probability of visual acuity improvement (≥0.3 logarithm of the minimal angle of resolution units improvement) was 39% at 1 month, 49% at 3 months, 52% at 6 months, and 58% at 12 months. Eyes with baseline vitritis (vitreous haze score ≥+0.5, n = 45) had a probability of vitreous haze score improvement (2-step decrease or change from +0.5 to 0) at 2 weeks of 41%, at 1 month 63%, at 3 months 73%, at 6 months 79%, and at 12 months 88%. In eyes that completed 12-month follow-up (n = 54), 40.7% underwent 2 injections (mean time to second injection of 6.6 ± 1.9 months) and 11.2% required ≥3 injections (mean time to third injection of 11 ± 1.5 months).

CONCLUSIONS:

Dexamethasone implant use in uveitis provides favorable visual acuity and vitreous haze score outcomes but requires repeated injections, an important consideration when choosing intraocular treatment as a route to controlling uveitis.

PMID:
25217856
DOI:
10.1016/j.ajo.2014.09.003
[Indexed for MEDLINE]

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