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R. B. Rush, J. Davis, D. Goldstein, H. Tessler, P. Lin, B. Meghpara; Birdshot Chorioretinopathy and Fluocinolone Acetonide Intravitreal Sustained Release Devices: an Analysis of Efficacy and Complications. Invest. Ophthalmol. Vis. Sci. 2009;50(13):6044.
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To evaluate outcomes of patients with birdshot chorioretinopathy (BSCR) who underwent implantation with the fluocinolone acetonide intravitreal sustained release device (Retisert).
Following Retisert implantation in one or both eyes, data was collected on HLA-A29 positive patients diagnosed with BSCR at baseline and follow-up visits at four months, one year, two years, and three years. The main outcome measures were visual acuity, cataract progression, development and progression of glaucoma, intraocular inflammation control, and the further need for either local or systemic therapy in addition to the Retisert implant in order to sufficiently control intraocular inflammation.
31 eyes of 19 patients underwent Retisert implantation. The average Snellen visual acuity improved from a mean of 20/66 at baseline to 20/46 at four months, 20/50 at one year, and 20/46 at two years. 92% of the study eyes required cataract surgeries at two years follow-up. 83% of the study eyes developed steroid-induced glaucoma at two years follow-up with 33% requiring glaucoma filtration surgery. 67% of the study eyes remained uninflamed without the need for additional local or systemic treatment, and all study eyes remained free from systemic treatment at the two year follow-up mark. Insufficient data was available for analysis at three year follow-up.
Retisert implantation in patients with BSCR can be an effective treatment option to control inflammation and stabilize vision as well as eliminate the need for systemic therapies and reduce the need for local therapies. However, the incidence of cataract progression and the development of steroid-induced glaucoma in patients with BSCR after Retisert implantation are high.
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