Abstract
Purpose :
Short acting intravitreal dexamethasone injections have been used to treat infectious endophthalmitis and toxoplasma chorioretinitis, but there is a paucity of data regarding its utility for non-infectious uveitis. We report the clinical outcomes of a series of patients treated with short acting intravitreal dexamethasone injections for non-infectious uveitis.
Methods :
A retrospective case series of patients with non-infectious uveitis seen at a tertiary referral practice between January 2021 and July 2023 is presented. Patients received a short acting dexamethasone 0.2 mg/0.05mL injection for uveitic cystoid macular edema with associated chronic anterior uveitis, intermediate uveitis, or panuveitis. Primary outcomes were best corrected visual acuity (BCVA) and optical coherence tomography (OCT) central subfield thickness (CST). A secondary outcome was anterior chamber (AC) cell grade. We hypothesized patients would have stable or improved BCVA, improvement in OCT CST by at least 10%, and decreased anterior chamber (AC) cell grade. Paired t-tests were used to compare the pre- and post-injection variables.
Results :
Twelve eyes of 9 patients with non-infectious uveitis were treated with short acting intravitreal dexamethasone injections during the study period. The mean duration of follow-up was 31.2 +/- 11.7 days (range 10-46 days). The pre- and post-injection mean BCVA were 20/100 and 20/80 respectively (N=12) (p=0.100). BCVA was stable or improved in all eyes with 3 eyes having greater than 2 lines of improvement at follow-up. The mean OCT CST on the day of the injection was 502.1 +/- 216.5 µm and decreased to 423.9 +/- 138.3 µm at follow-up (N=10) (p=0.098). Seven of 10 eyes showed stable or reduced CST by 10%. The average pre-injection AC cell grade was 1+ cell (+/- 1.01) and was largely unchanged at 1.05+ cell (+/- 1.01) at follow-up (N=10) (p=0.751). There were no serious adverse events observed during the study period.
Conclusions :
Short acting intravitreal dexamethasone injections are a safe treatment for non-infectious uveitis. Visual acuity and macular edema improved in some patients without notable change in AC cell grade, suggesting they may be more appropriate for uveitic macular edema than inflammatory parameters.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.