Ozurdex in Active Intermediate & Posterior Uveitis Needing Immunosuppression
Purpose
To determine if the intravitreal dexamethasone pellet (DEX, Ozurdex, Allergan [Irvine, CA]) can be used instead of oral corticosteroid (CS) to control active intermediate or posterior uveitis in patients (pt) needing immunosuppression (IMT).
Methods
Proof of concept, interventional study of pt with active intermediate or posterior uveitis. All pt received DEX and were followed prospectively at month (mo) 1, 3, 6, 9 and 12. Primary outcomes were control of uveitis while on IMT without adding oral CS at 6 and 12 mo. Need for multiple DEX or for additional oral CS, relapse of uveitis, and safety data were secondary outcomes.
Results
20 pt were enrolled; 12 had control of uveitis by 6 mo, 13 by 12 mo. No pt required high-dose CS. 16 eyes of 13 pt required multiple DEX by 12 mo (median=3, range 2-5). Control of anterior chamber reaction, vitreous reaction, chorioretinal lesions, and CME was similar to bridge therapy with oral CS. All pt were able to taper oral CS. 16 pt discontinued oral CS; 4 pt remained on oral CS (median dose of prednisone=5mg, range 3-7.5mg daily at 12 mo). The rates of OHT and cataract were higher than those reported for oral CS in the literature. There were no cases of endophthalmitis, vitreous hemorrhage; retinal detachment.
Conclusion
The DEX implant appeared effective in controlling the active inflammation and CME of intermediate and posterior uveitis without use of high-dose CS. Multiple implants were required in a majority; pt were able to decrease or stop preexisting oral CS in follow-up.
Conflict of interest
No
Author 1
Last name
BERKENSTOCK
Initials of first name(s)
M
Department
Wilmer Eye Institute
City
Baltimore
Country
United States
Author 2
Last name
Mir
Initials of first name(s)
T
Department
Yale Department of Ophthalmology
City
new haven
Country
United States
Author 3
Last name
Burkholder
Initials of first name(s)
B
Department
Wilmer Eye Institute
City
baltimore
Country
United States
Author 4
Last name
Thorne
Initials of first name(s)
J
Department
Wilmer Eye Institute
City
baltimore
Country
United States
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