Abstract
Purpose::
To report the three-year results of cystoid macular edema from non-infectious uveitis treated with an intravitreal fluocinolone acetonide implant.
Methods::
Two hundred and seventy-eight patients with recurrent noninfectious posterior uveitis were randomized to receive a 0.59-mg (n=110) or 2.1-mg (n=168) intravitreal fluocinolone acetonide implant. In patients with bilateral disease, the more severely affected eye received the implant. The primary outcome variable was area of CME reduction seen on fluorescein angiograms taken at 300 sec. CME was assessed by angiograms taken at week 8, week 34, 1,2, and 3 years post-implantation and read by masked evaluators at REDIARC (retinal diseases image analysis reading center).
Results::
Combining both doses, 56.8% (54/95) of study eyes showed a reduction in the area of CME between baseline and 3-year post-implantation, compared with 24.2% (23/95) of fellow eyes (p< 0.0001). Morphometric analysis restricted to those subjects presenting with bilateral disease at baseline gave qualitatively similar results that were also statistically significant for study versus fellow eyes for the 0.59 mg group and the combined group, but not for the 2.1 mg dose group. An analysis of CME patterns and fluocinolone impact with regard to underlying cause of uveitis will be reported.
Conclusions::
Cystoid macular edema is a sight threatening complication of posterior segment uveitis and plays a decisive role in the visual outcome of this disease. At the 3-year period the fluocinolone acetonide implant showed a significative reduction in the area of angiographic CME of the eyes studied. Underlying disease, pattern and severity of CME influence clinical response and improvement in visual acuity.Supported by: NIH P30EY11373, juvenile Diabetes Fdn Inter., Ohio Lions Eye Research Fdn., CWRU Retina Research Fund, and Research to Prevent Blindness, Inc.
Keywords: clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials • retina • uvea