Abstract
Purpose :
FAi has been proven effective at controlling inflammation in eyes with noninfectious intermediate, posterior/panuveitis. However, real-world clinical data to guide medication and treatment recommendations is scarce. Here we report a large retrospective analysis of FAi and its effect on corticosteroid and immunosuppressive burden
Methods :
Chart review was performed on 105 eyes treated with FAi and followed for 3 years. Outcome variables were clinically defined recurrence of “active inflammation”, as well as increased oral corticosteroid use, periocular corticosteroid injections, and immunosuppressive medication burden (number of medications and dose). Adverse effects of increased intraocular pressure, glaucoma drops, and incident cataract surgery were also measured. Statistical analyses were conducted using R version 4.2.2. Two-sided p < 0.05 was considered statistically significant
Results :
82 of the 94 eyes being treated with oral corticosteroid had a dose of 7.5mg or lower at every annual post-injection visit. 29 eyes were on systemic immunosuppression before FAi, with 9, 11, and 6 patients on immunosuppression at follow-up years 1,2, and 3.
Intraocular pressure spikes were concentrated within the first year with 11 events seen (10%), however, glaucoma regimen increases were more evenly distributed with 16, 10, and 9 events of increased glaucoma management at years 1,2,and 3. In contrast, cataract surgeries were concentrated in the later years- with 4 phakic eyes getting surgery after follow-up year 1 versus 8 after year 2.
Pearson’s Chi-Squared test and Wilcoxon tests showed no change in outcomes when adjusting covariates such as age, race, sex, lens status, or anatomic location of uveitis across any of our outcomes.
Conclusions :
Our data analysis shows a persistent reduction in median oral corticosteroid dose, periocular corticosteroid injection usage, and immunosuppressive dose/regimen across our cohort relative to their pre-FAi baseline medication regimens. Notably, the reduction in regimen remains consistent across all three years. Adverse effects were seen, with 17 out of 22 phakic eyes requiring cataract surgery by the third follow-up year.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.