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George R Mount, Laura J Kopplin, Fran Wu, Sarah Read-Brown, Phoebe Lin, Eric B Suhler, James T Rosenbaum; Effectiveness and potential complications of difluprednate use for HLA-B27 associated acute anterior uveitis.. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1878.
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© 2017 Association for Research in Vision and Ophthalmology.
To assess the effectiveness and complications of topical difluprednate use in patients with HLA-B27 associated acute anterior uveitis.
We conducted a single center retrospective chart review of patients prescribed difluprednate from January 2009 to December 2012 by the Casey Eye Institute uveitis division. Eleven eyes of 10 patients (4 male, 6 female, of age ranging 18-58 years) with HLA-B27 associated acute anterior uveitis treated with topical difluprednate were evaluated. We recorded anterior cell and flare grade, visual acuity, and intraocular pressure (IOP) at each visit. Outcome measures included changes in anterior segment cell, visual acuity, IOP response and development of a visually significant cataract.
We observed a significant (≥ 2-grade decrease or decrease to 0 in anterior segment cell) reduction in anterior segment inflammation in 78% of eyes (7/9) when difluprednate was used as primary therapy, and in 100% of eyes (2/2) when used in conjunction with a systemic immunosuppressive. This response was seen within one month of therapy initiation in 89% of eyes (8/9). A significant IOP response (IOP increase of ≥ 10 mm Hg from baseline or IOP ≥ 24 mm Hg) was seen in 18% of eyes (2/11). 1 of 10 patients received local corticosteroid injection therapy within the six months prior to initiation of difluprednate. 1 of 10 patients required both cataract and glaucoma surgery within a year of starting therapy.
In our study, difluprednate was an effective agent for rapid control of anterior segment inflammation in patients with HLA-B27 associated acute anterior uveitis. A low rate of steroid-induced IOP elevation and cataract formation was seen in this population.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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