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Laura Pelegrin, Marina Mesquida, Victor Llorens, Blanca Molins, Maite Sainz de la Maza, Alfredo Adan Civera; Long-term evaluation of non-infectious uveitic macular edema treated with Ozurdex. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5299.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the long-term visual prognosis and complications of patients who received intravitreal Ozurdex injections for the treatment of non-infectious uveitic macular edema (UME).
A retrospective study of 32 patients with UME refractory to systemic and intraocular therapies were treated with intravitreal dexamethasone. Vitrectomized (PPV) versus non vitrectomized (non-PPV) patients were analyzed. The main variables analyzed were the reduction in central retinal thickness (CRT), best corrected visual acuity (BCVA) and intraocular pressure (IOP). Activity status of uveitis and side effects were also assessed. Statistical analysis was adjusted by the presence of vitrectomy, reinjection of dexamethasone during follow-up and number of treatments for high IOP. These estimations of effects were performed by means of Longitudinal Linear model using the General Estimating Equation (GEE) methodology to account for intra-subject correlations for visits with the assumption of first degree dependence of correlation
The median age of patients was 46,7 years (range, 18-61 years). The mean follow-up time was 38,5 months. The CRT (95% confidence interval) was 571.9 microns (476.1-667.9) in non-PPV patients and 509,63 (428,3; 590,9) in PPV patients at baseline, its maximum decrease was at first month, 320,53 (266,09; 374,9) and 278,74 (224,6; 332,8) respectively which was maintained all over the follow-up BCVA logMar improved from 0,912 (0,685; 1,139) at baseline to 0,651 (0,428; 0,873) at 3 months in non-PPV patients and from 0,875 (0,682; 1,067) to 0,522 (0,35; 0,694) in PPV patients. IOP showed statistically differences of 3,82 mmHg (p=0,012) between non-PPV and PPV patients from third to twelfth month 4,5 mmHg (p=0,001) In 22 eyes (50%), reinjection of the implant was performed at a mean of 4.8 months. Ocular hypertension (50%), hypotony (7.1%), anterior chamber displacement of the implant (4.7%), cataract surgery (7,1%) and glaucoma, which required filtration surgery (4.7%), were the most common adverse events.
Our results indicate that treatment with dexamethasone intravitreal implant injection for uveitic macular edema has favorable long-term safety profile. IOP shows statistically differences between PPV and non-PPV patients
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