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Jennifer Cao, Matthew L Mulvahill, Li Zhang, Brian C Joondeph, Mark S Dacey; Dexamethasone Intravitreal Implant in the Treatment of Persistent Uveitic Macular Edema in the Absence of Active Inflammation. Invest. Ophthalmol. Vis. Sci. 2014;55(13):2852.
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© ARVO (1962-2015); The Authors (2016-present)
To examine the observational effectiveness of the dexamethasone (DEX) intravitreal implant (Ozurdex®; Allergan, Inc, Irvine, CA, USA) in the treatment of non-infectious uveitic macular edema in patients with otherwise quiescent uveitis.
This is a retrospective chart review of twenty seven consecutive patients (33 eyes) with persistent macular edema resistant to standard short-term therapy despite quiescent non-infectious intermediate and posterior uveitis. Each patient was treated with a DEX 0.7 mg implant. Primary outcome measure was resolution of macular edema as measured by decrease in central macular thickness. Secondary outcome was change in visual acuity at 1, 2, and 3 months post-injection.
Twenty seven eyes of twenty seven patients were included for analysis (one eye was randomly selected for six of these patients receiving bilateral DEX implants). There was a statistically significant reduction in mean central macular thickness at 1 month post-DEX implantation (mean 278.9um, range 206-352) compared to baseline (mean 478.7 um, range 330-667um) (p<0.0001). There was a statistically significant improvement in visual acuity at 3 months (LogMAR 0.42; 20/50-1) compared to baseline (LogMAR 0.61; 20/80+) (p=0.0007). There were no major complications following DEX implantation.
The DEX implant resulted in a statistically significant improvement in mean central macular thickness and visual acuity without any serious adverse events. Our study suggests that the DEX implant may be a useful treatment modality in the successful management of uveitic CME, even in the absence of active inflammation, and may be an effective agent that may allow patients to delay more invasive treatment such as pars plana vitrectomy.
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