Intravitreal dexamethasone implant in non-infectious uveitis : a one-year follow-up

Abstract

Purpose: To evaluate the 12-month outcome of the dexamethasone intravitreal implant in patients with non-infectious uveitis

Methods: Retrospective consecutive case series of 42 eyes of 33 patients with non infectious uveitis and macular edema who received an intravitreal dexamethasone implant with a minimal follow-up of 12 months.

Results: The files of 33 patients were studied : 17 idiopathic uveitis , 9 sarcoidosis , 2 Behcet's disease , 2 VKH , 1 ankylosing spondylitis , 1 psoriatic arthritis , 1 birdshot retinochoroidopathy. At 1 year, seven patients (21%) had no recurrence after one injection. 19 patients (58%) relapsed, with the median time to relapse being 6.2 months (2-11 months) but inflammatory signs started to reappear from 3.5 months. Among these patients, 8 received two injections and 2 received 3 injections. The reinjection interval was 7.5 months (4-11 months). Immunosuppressive therapy or corticosteroids were introduced for 3 and 2 patients, respectively. One patient received a subtenon injection of triamcinolone and 3 were just monitored without an adjuvant treatment. Injection was ineffective for 2 patients. Visual acuity remained stable before and 6 months after the first injection (respectively 0.82 and 0.86 log MAR). 8 patients (24%) developed a significant rise in intraocular pressure but all resolved with local therapy. One patient experienced an intravitreal hemorrhage.

Conclusions: Dexamethasone intravitreal implant was effective for macular edema related to uveitis with a good safety. Six months after treatment, the recurrence rate was high. Dexamethasone implant may be used as first-line in selected cases and may also be useful in association with systemic therapy.

Keywords: 746 uveitis-clinical/animal model • 557 inflammation • 462 clinical (human) or epidemiologic studies: outcomes/complications