Abstract
Purpose: :
To evaluate the efficacy of intravitreal dexamethasone implant (Ozurdex®) in eyes with chronic uveitis with or without cystoid macular edema.
Methods: :
Retrospective case series of 20 consecutive eyes (18 patients, mean age 49 +/- 21 years) with chronic uveitis (> 3 years). Visual acuity, foveal retinal thickness, a full ophthalmological examination and history of immunosuppressive medication (11 / 18 patients) were obtained before injection and over the course (54 days +/- 41 days) after injection. 13 / 20 eyes had cystoid macular edema (CME).
Results: :
In all eyes dexamethasone intravitreal implant could be implanted successfully. Mean visual acuity LogMAR increased from 0.82 to 0.65 after an average of 35 days. CME was reduced in 8 of 13 eyes after 35 days (median). Immunosuppressive medication could be reduced in 9 of 11 patients, 2 patients continued their medication because of uveitis in the second eye. The main intraoperative complications were one subconjuctival substance-release before scleral penetration, a postoperative increase of intraocular pressure in 5 out of 20 eyes, which could be controlled with topical therapy, one retinal detachment and one dislocation of the device into the anterior chamber in an aphacic and vitrecomized eye. First loss of efficacy was observed 3-4 months after injection.
Conclusions: :
Dexamethasone intravitreal implant can improve visual acuity and reduce CME and concomitant immunosuppressive medication in patients with chronic uveitis. The observed efficacy lasts for at least 3 months, and we propose a contraindication for aphacic eyes.
Keywords: uveitis-clinical/animal model • autoimmune disease • macula/fovea