Pohlmann D, et al. - Researchers aimed at reporting the effectiveness of repeated intravitreal dexamethasone (DEX) inserts in noninfectious uveitis patients. Improvement in central retinal thickness (CRT), best-corrected visual acuity (BCVA), and vitreous haze (VH) score was achieved with repeated longer-term administration of DEX inserts among these patients, either alone or in combination with other therapies. Underlying diseases and concomitant systemic therapy appeared influencing the overall treatment benefit. With exception of cataract formation, ocular complications were reversible and were managed by local treatment.

Methods

• A 700-μg intravitreal DEX insert (Ozurdex; Allergan, Inc., Irvine, CA) was used for treatment of patients.
• Researchers scheduled the follow-up visits 1, 3, and 6 months after injection.
• They recorded BCVA, CRT, VH score, intraocular pressure (IOP), and adverse events.
• The reduction of CRT was assessed as primary outcome.
• The improvement in BCVA and reduction of VH were assessed as secondary outcome.

Results

• Two hundred and ninety eight DEX inserts were injected in 109 eyes of 76 patients.
• Researchers noticed that 52 patients were women (68%).
• Participants had mean age of 57 years (range, 24–88 years).
• In 44% of eyes, more than 3 DEX inserts were injected.
• Over 12, 18, and 24 months, mean number of injections were 1.54±0.5 (standard deviation [SD]), 1.98±0.84, and 2.46±1.1, respectively.
• Findings suggested a significant decrease in central retinal thickness (P < 0.001) from 465 μm at baseline to 318, 342, and 388 μm after 1, 3, and 6 months, respectively.
• Eyes receiving a second, third, and fourth DEX insert showed similar trends.
• Patients with idiopathic uveitis and sarcoidosis benefited well from DEX inserts.
• Patients with no systemic treatment and patients receiving antimetabolites and cyclosporin A showed the greatest overall benefit.
• In 44% of eyes, a significant VH score reduction was reorted after 1 month.
• In BCVA, a gain of more than 3 lines was recorded in 31% to 37%, 26% to 39%, and 8% to 32% of eyes after 1, 3, and 6 months, respectively.
• They observed a transient rise in mean IOP after 1 month (P < 0.001) and after 3 months (P=0.001).