June 2013
Volume 54, Issue 15
ARVO Annual Meeting Abstract  |   June 2013
Risk Factors Associated with Intraocular Pressure Rise in Patients with Uveitis Treated with the Fluocinolone Acetonide Implant
Author Affiliations & Notes
  • Anjali Parekh
    Ophthalmology, Northwestern Medical Faculty Foundation, Chicago, IL
  • Sunil Srivastava
    Ophthalmology, Cole Eye Institute, Cleveland, OH
  • Thomas Albini
    Ophthalmology, Bascom Palmer Eye Institute, Miami, FL
  • Quan Dong Nguyen
    Ophthalmology, Wilmer Eye Institute, Baltimore, MD
  • Debra Goldstein
    Ophthalmology, Northwestern Medical Faculty Foundation, Chicago, IL
  • Footnotes
    Commercial Relationships Anjali Parekh, None; Sunil Srivastava, Bausch and Lomb (F), Bausch and Lomb (C), Novartis (F), Allergan (F); Thomas Albini, Bausch and Lomb (C), Allergan (C), Genentech (F), Eleven Biotherapeutics (C); Quan Dong Nguyen, Genentech (F), Regeneron (F), Lux Biosciences (F), Abbott (F), GSK (F), Santen (F), Santen (C), Bausch and Lomb (C), Optos (F), Heidelberg Engineering (F); Debra Goldstein, Bausch and Lomb (C), Bausch and Lomb (R)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 5196. doi:
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      Anjali Parekh, Sunil Srivastava, Thomas Albini, Quan Dong Nguyen, Debra Goldstein; Risk Factors Associated with Intraocular Pressure Rise in Patients with Uveitis Treated with the Fluocinolone Acetonide Implant. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5196.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose: The fluocinolone acetonide (FA) intravitreal implant (Retisert; Bausch & Lomb, Inc., Rochester, New York, USA) is an FDA approved therapy for the treatment of chronic non-infectious intermediate, posterior, and pan-uveitis. The efficacy of this implant has been demonstrated by three 3 year multicenter, prospective, randomized clinical trials. Elevated intraocular pressure is a well-known adverse event secondary to the use of the FA intravitreal implant. In a study evaluating the incidence and management of elevated IOP in patients with uveitis treated with the FA implant, topical IOP lowering medications were administered in 74.8% of implanted eyes, and IOP lowering surgeries were performed in 36.6% of implanted eyes by 3 years. The purpose of this investigation is to report associated patient risk factors that may predispose to elevated intraocular pressure following treatment with the intravitreal FA implant

Methods: Pooled data from the previously published 3 multicenter, double-masked, randomized, controlled phase 2b/3 clinical trials evaluating the safety and efficacy of the 0.59 mg or 2.1mg FA intravitreal implant were analyzed to characterize risk factors associated with elevated IOP. Risk factors studied included age, gender, race, and location of uveitis. All eyes implanted with either the 0.59mg FA implant or the 2.1mg FA implant were included in the analysis. Frequencies of patients with glaucoma surgery were compared using Pearson chi-square or Fisher exact tests for categorical factors and t-tests for continuous measures. Analyses were performed in SAS software and used a 0.05 significance level.

Results: 290 eyes received an FA implant. Male gender was associated with an increased risk of requiring glaucoma surgery (p= 0.037), as was younger age (p= 0.006). No statistically significant difference was found between Caucasians and non-Caucasian patients. (p=0.38) Patients with posterior uveitis were more likely than those with anterior, intermediate, or panuveitis to require surgery (p=0.006).

Conclusions: The risk of requiring glaucoma surgery in this series was highest in males, younger patients and those with posterior uveitis. This information can be used to counsel patients considering treatment with the FA implant.

Keywords: 568 intraocular pressure • 557 inflammation • 688 retina  

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