Abstract
Purpose :
To compare the efficacy of intravitreal triamcinolone acetonide (Triesence®, IVT) and intravitreal dexamethasone implants (Ozurdex®, OZD) for cases of non-infectious posterior uveitis.
Methods :
A clinical database was queried to identify all eyes treated with IVT or OZD from 2018 through 2020 at the University of California, Davis Health System. Clinical and imaging data, including visual acuity (VA), intraocular pressure (IOP), use of systemic immunomodulatory therapy (IMT), and central macular thickness (CMT) on optical coherence tomography were analyzed before and after their most recent IVT or OZD treatment. Eyes were excluded if there was a concurrent diagnosis of other fundus pathology (e.g. diabetic retinopathy, retinal vein occlusion), a lack of follow-up after treatment, or no light perception VA.
Results :
22 eyes from 16 patients (4 men, 12 women) were identified that met inclusion criteria. The average age at time of treatment was 67.3 years (range 37.7-98.4). The distribution of non-infectious uveitis amongst the eyes were: 15 idiopathic, 4 sarcoid, 2 tubulointerstitial nephritis and uveitis syndrome, and 1 Vogt-Koyanagi-Harada. 12 eyes received IVT (54.5%) and 10 eyes received OZD (45.5%). Only four eyes (three patients) were on systemic IMT at the time of injection. The patients were followed for a mean of 145.5+/-31.7 days for IVT and 160.5+/-34.7 days for OZD. Overall, there was a statistically significant improvement in LogMAR VA (-0.17, p=0.03), and reduction in CMT (-70.1 microns, p=0.01) after treatment, while there was no difference in IOP compared to baseline (p=0.26). The change in LogMAR VA after IVT treatment was -0.105+/-0.06 and after OZD treatment was -0.245+/-0.14, which was not statistically significant between groups (p=0.37). The change in CMT was -81.33 microns after IVT treatment, and -56.6 microns after OZD treatment, which was not significantly different between groups (p=0.6370).
Conclusions :
The use of intravitreal steroid resulted in a significant improvement in VA, and CMT on OCT without significantly affecting IOP in eyes with non-infectious uveitis. No significant different was noted in visual acuity and CMT change in following OZD when compared to IVT in this small retrospective study. While there was a trend towards better visual and imaging outcomes in eyes treated with OZD, it was not statistically significant.
This is a 2021 ARVO Annual Meeting abstract.