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Arnd Heiligenhaus, Marc Breitbach, Dorothee Rack, Martha Dietzel, Carsten Heinz; Efficacy of the dexamethasone implant Ozurdex® for the re-treatment of refractive cystoid macular edema in non-infectious uveitis.. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5807.
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To evaluate the efficacy of a second intravitreal dexamethasone implant (Ozurdex®) in patients with cystoid macular oedema (CME) suffering from non-infectious uveitis.
Monocentric, retrospective, single-arm analysis in 21 patients (23 eyes) with inactive non-infectious uveitis, in whom CME had been unresponsive to corticosteroids and/or immunosuppressants and systemic acetazolamide, and who received a dexamethasone implant (Ozurdex®). All patients received a second implant after the effect of the first had terminated. Patients were followed up at 6, 12 and 24 weeks after implantation. The primary outcome measure was central foveal thickness (CFT), spectralis optical coherence tomography (OCT); secondary outcome measures were improvement in best-corrected visual acuity (BCVA), and safety measures including intraocular pressure (IOP) and cataract progression.
The re-injection was performed at a mean of 34 weeks after the first injection. At 6, 12, and 24 weeks after re-injection, mean CFT was reduced (≥ 20%) in 60%, 50%, and 33%, respectively; BCVA improved (≥ 2 lines) in 45%, 38%; and 24%, respectively, as compared to baseline. Mean IOP increased from 13.9 mmHg to 15.4 mmHg (p=0,11), and was ≥ 22 mmHg in only one eye. Response to the first and re-injection was similar.
In uveitis patients with CME refractive to systemic anti-inflammatory drugs, the dexamethasone implant improves CME transiently. Response to re-treatment was similar to the first injection.
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