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Sunil K. Srivastava, Quan D. Nguyen, David Callanan, Debra A. Goldstein, Thomas A. Albini; The Use Of The Fluocinolone Acetonide (Retisert) Implant In Patients With Birdshot Choroidopathy. Invest. Ophthalmol. Vis. Sci. 2011;52(14):2751.
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To describe the clinical outcomes of the subgroup of patients with birdshot choroidopathy enrolled in the fluocinolone acetonide (Retisert) randomized clinical trials.
Data from 3 separate randomized controlled clinical trials performed from 2000-2005 was compiled. Patients with evidence of birdshot choroidopathy were identified from the data set and analyzed. Outcome measures analyzed included recurrence rates, ETDRS visual acuity, time to first recurrence, visual fields, angiographic evidence of leakage and ERG.
A total of 39 patients were identified, 31 patients were randomized to receive fluocinolone acetonide implantation and 8 randomized to standard of care (SOC) medications. Only one eye from each group was used as the study eye. Data was also collected on the fellow eye in the implant group. The average patient age was 46. 26 patients were female, 13 were male. Logmar baseline vision in the implant group was .5067, in the standard of care group was .635 and the fellow eye of the implant group was .2467. 36 month visual acuity results revealed stabilization in the implant group and worsening in both the SOC and fellow eye groups. Recurrence rates over 3 years in the implant group was 22%, 62% in the SOC group and 46% in the fellow eye group. Average time to recurrence was 603 days in the implant group, 430 days in the SOC group and 118 days in the fellow eye group.
In the subgroup of patients with birdshot choroidopathy, eyes implanted with the fluocinolone acetonide implant maintained stable vision over a period of 36 months with a lower recurrence rate and longer time to recurrence in comparision to eyes treated with standard of care medications and fellow non-implanted eyes. This study is limited by the small number of patients, but represents one of the largest series examining the use of the fluocinolone acetonide implant in birdshot patients.
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