Purpose:
To evaluate the effect of topical difluprednate in the treatmentof refractory intraocular inflammation.
Methods:
Retrospective chart analysis of 52 patients seen in a uveitisspecialty clinic treated between January 1, 2009 to June 10,2010 with topical difluprednate for the treatment of intraocularinflammation. Baseline data included age, diagnosis, baselinevisual acuity, intraocular pressure (IOP), cataract, and degreeof inflammation. Data recorded at each follow-up visit includedIOP, inflammation grade according to SUN criteria, need foradditional topical or systemic medication, and development ofcataracts. Clinical response to treatment was measured as a2 unit decrease in AC inflammation grade as outlined by SUNcriteria.
Results:
The average time to a 2 unit decrease in AC inflammation inpatients who initially started with 2 units or more cell was51.70 +/- 63.08 days. The average time to resolution of AC inflammation,defined as an AC cell grade of 0 (<5 cells) was 84.12 +/-76.28 days in 33/44 patients. At baseline, 2 patients (3.8%)were on 1 topical anti-hypertensive medication, and 1 patient(1.9%) was managed with 2 topical anti-hypertensives. At thefinal visit, 8 patients (15.4%) required IOP control with 2anti-hypertensive medications, 3 patients (5.8%) required 3anti-hypertensive medications, and 1 patient (1.9%) requireda surgical shunt procedure.
Conclusions:
Initial results show that difluprednate is an effective medicationfor the treatment of intraocular inflammation. However, cliniciansmust monitor patients closely for the development of complications,particularly elevated IOP, and manage these complications accordingly.
Keywords: inflammation • uveitis-clinical/animal model