July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Dexamethasone Intravitreal Implantation To Treat Uveitic Macular Edema
Author Affiliations & Notes
  • Grace Levy-Clarke
    Clinical Research, Tampa Bay Uveitis Center, LLC, Safety harbor, Florida, United States
  • Jeffrey Wipfli
    St Luke's Cataract and Laser Institute, Florida, United States
  • Nandesh N. Patel
    Orlick, Berger, Kasper and Patel, Florida, United States
  • Mireya Benitez Cartaya
    Clinical Research, Tampa Bay Uveitis Center, LLC, Safety harbor, Florida, United States
  • John H Kempen
    Massachusetts Eye and Ear, Massachusetts, United States
  • Footnotes
    Commercial Relationships   Grace Levy-Clarke, AbbVie (C), Allergan (F), Mallinckrodt (F), Sanofi/Genzyme (F); Jeffrey Wipfli, None; Nandesh Patel, None; Mireya Benitez Cartaya, None; John Kempen, Alcon (C), Allergan (C), Can-Fite (C), Clearside (C), Lux Biosciences (C), Sanofi-Pasteur (C), Xoma (C)
  • Footnotes
    Support  Allergan Publication Grant
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 3512. doi:
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    • Get Citation

      Grace Levy-Clarke, Jeffrey Wipfli, Nandesh N. Patel, Mireya Benitez Cartaya, John H Kempen; Dexamethasone Intravitreal Implantation To Treat Uveitic Macular Edema. Invest. Ophthalmol. Vis. Sci. 2019;60(9):3512.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose : To investigate uveitic macular edema resolution following dexamethasone intravitreal implantation in pseudophakes and patients scheduled for imminent cataract extraction.
Uveitic macular edema causes a plurality of vision loss in uveitis, decreasing the visual acuity (VA) to <20/40 in about one-third of uveitis patients with involvement of the posterior pole. It has been reported that uveitic macular edema frequently occurs in panuveitis and intermediate uveitis, with an incidence of 66% and 65%, respectively.

Methods : Patients were identified in the Tampa Bay Uveitis Center database. Demographic and clinical characteristics were obtained at every visit via medical record review. The outcome measures included:
Improvement of macular edema: Resolution (central foveal thickness <300µ); improvement (decrease in retinal thickness >30%); Improvement in visual acuity (to 20/40 or better and/or >2 line on ETDRS scale); Documentation of adverse events

Results : The follow-up period ranged from 3-15 months: 15/16 eyes (93.8%, 95% confidence interval (CI): 69.8%-99.8%) met the pre-specified primary outcome of resolution of macular edema, 1/16 had improvement, decrease in retinal thickness >30% (6.3%, 95% confidence interval (CI): 0.16%-30.2%). Visual acuity met criteria for improvement in 13/16, increase to 20/40 or better (81.3%, 95% CI: 54.4%-96.0%); 2/16 (12.5%, 95% CI: 2.6%-38.3%) showed no visual improvement; 1/16 showed stabilization of baseline visual acuity at 20/40. Adverse events included elevated intraocular pressure (IOP): 1/16 eyes responded to medical therapy and 1/16 eyes required implantation of a Baerveldt valve for IOP control.

Conclusions : Dexamethasone intravitreal implantation was effective in treating uveitic macular edema and in improving reduced visual acuity attributed to the macular edema in a majority of the participants, consistent with previous reports. This pilot study shows the potential utility of dexamethasone intravitreal implantation in pseudophakes or for imminent cataract surgery management. The removal of the confounding complication of cataract development and cataract-induced reversible visual acuity loss is a strength of this report. A larger prospective study would be instructive in imminent cataract surgery management, which still is a major issue for uveitis patients.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.



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