Abstract
Purpose :
We sought to investigate the risk of posterior subcapsular cataract development amongst patients treated for uveitis with 0.05% topical difluprednate.
Methods :
This is a retrospective cohort study assessing patients with uveitis who were treated with topical difluprednate from January 1st, 2016 through October 30th, 2020 at an academic medical center. Thirty patients (forty eyes) were evaluated through a chart review to collect clinical data which was then analyzed. Patients that received cataract surgery before being treated with difluprednate for uveitis were excluded.
Results :
Twelve eyes (30%) were observed to have had development or progression of PSC. For the eyes that developed a PSC, both the duration (mean of 17.3 weeks versus 13.7 weeks) and total cumulative dose (mean of 334 drops versus 271.6 drops) of topical difluprednate were higher compared to patients who did not develop a PSC. The average time to development of a PSC noted on eye exam after the initiation of difluprednate was 12.9 months. Nine eyes (30%) were noted to have ocular hypertension at some point during the follow-up period, and all of these eyes were controlled with pressure-lowering drops. The current data collection and analysis will continue to include information on confounding variables such as additional topical and oral steroid use, posterior sub-tenon kenalog injections, presence of active uveitis, as well as a stratification of daily drop use and duration of treatment.
Conclusions :
In our cohort of uveitis patients, we have found that an increased duration and cumulative dosing of difluprednate treatment is associated with an increased risk of posterior subcapsular cataract formation. Based on our current collected data, we predict that this finding will be significant when controlling for other variables associated with formation of PSC. This is one of only a few studies that have assessed the impact of topical difluprednate on cataract formation in an adult uveitic population. We believe this study will provide further clinical insight into the safety profile and dosing of difluprednate, as well as contribute to our knowledge of topical steroid treatment regimens for patients with uveitis.
This is a 2021 ARVO Annual Meeting abstract.