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Heloisa Nascimento, Maíra França, Luciana García, Cristina Muccioli, Rubens Belfort, Jr.; Subconjunctival Ozurdex® (Off-label indication) for Scleritis. Invest. Ophthalmol. Vis. Sci. 2012;53(14):2768.
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To report the management of anterior scleritis with off-label subconjunctival implant of Ozurdex® (slow release 0.7mg dexamethasone drug delivery system).
Six patients with clinical diagnosis of anterior scleritis (diffuse, sectorial and nodular) were submitted to subconjunctival injection of Ozurdex®. The injection was performed under topical anesthesia at the slit lamp. All patients reported only mild discomfort. Five patients had subconjunctival hemorrhage. Patients were followed on days 1, 7, 15, 30, 45, and 2, 3, 4, 5 and 6 months post procedure. Visual acuity, intraocular pressure, anterior and posterior biomicroscopy and fundus exam were performed in all visits.
In all patients symptoms disappeared before day 7 and most of them were symptoms free on day 2. The implant was visible at least up to day 45. One recurrence was noted in the 6-month follow-up in a patient with rheumatoid arthritis and diffuse scleritis. The recurrence occurred in the 6th month post procedure and was treated with oral steroids. No patient developed ocular hypertension or any kind of complications during the follow-up period.
Ozurdex® was safely and effectively used for the local treatment of scleritis. Potential advantages could include easier steroid removal in case of complications such as scleral melting or glaucoma. Also it would not mask systemic diseases signs and symptoms allowing proper diagnosis of the scleritis cause. Cost-effective relationship should be assessed.
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