June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
Dexamethasone intravitreal implant as monotherapy for birdshot chorioretinopathy
Author Affiliations & Notes
  • Minh Trinh
    Ophthalmology, Northwell Health, Great Neck, New York, United States
  • Jonathan Jonisch
    Vitreoretinal Consultants, Great Neck, New York, United States
  • Footnotes
    Commercial Relationships   Minh Trinh, None; Jonathan Jonisch, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 1400. doi:
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      Minh Trinh, Jonathan Jonisch; Dexamethasone intravitreal implant as monotherapy for birdshot chorioretinopathy. Invest. Ophthalmol. Vis. Sci. 2021;62(8):1400.

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

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Abstract

Purpose : Birdshot chorioretinopathy (BCR) is an ophthalmic disease not commonly associated with other systemic findings. However, systemic steroids or immunomodulatory therapy (IMT) is often needed to treat acute or chronic BCR, and those have significant morbidity associated with treatment. We present six eyes with BCR undergoing monotherapy with intravitreal dexamethasone implantation 0.7mg (Ozurdex; Allergan, Inc.) to review the efficacy and limitations of this treatment modality.

Methods : A retrospective chart review was performed on patients at our practice with BCR. Eyes receiving Ozurdex monotherapy for the treatment of BCR with a minimum follow-up period of 6 months were included. Eyes which were concurrently receiving systemic steroids or IMT were excluded. Six eyes (3 patients) were included. The main outcome measure was quiescence of disease activity as measured by fluorescein angiogram, optical coherence tomography, ophthalmic exam, and patient symptoms. Secondary outcomes were improvement of best corrected visual acuity. We collected: visual acuity, central macular thickness (CMT), presence of vitritis, presence of retinal vasculitis on fluorescein angiography, intraocular pressure (IOP), and presence of cataract at baseline, 1 month, 3 months, and 6 months after beginning treatment.

Results : All eyes were injected at intervals of 3-6 months if there was clinical evidence of worsening vision, macular edema, vitritis, or retinal vasculitis. All eyes achieved quiescence of disease activity with Ozurdex. The mean LogMar visual acuity was 0.18 ± 0.15 at baseline, 0.16 ± 0.10 at 1 month, 0.16 ± 0.12 at 3 months, and 0.13 ± 0.11 at 6 months (all p > 0.05). There was a trend towards improved visual acuity but was not statistically significant. One eye presented with macular edema with a CMT of 409 microns at baseline which improved to 248 microns at 6 months. Two eyes had vitritis and four eyes had retinal vasculitis, all eyes improved with treatment. Four eyes developed elevated IOP after the first injection of Ozurdex, but was successfully managed with topical therapy alone. None of our patients developed cataracts as a consequence of therapy.

Conclusions : Our findings suggest that repeated injections of Ozurdex as monotherapy may be a valuable option in the treatment of BCR and could be used to delay the initiation of IMT. Further studies are warranted to evaluate the utility of local monotherapy with Ozurdex.

This is a 2021 ARVO Annual Meeting abstract.

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