Dexamethasone implant shows promise for persistent uveitic macular edema

This retrospective study found that use of the dexamethasone intravitreal implant (Ozurdex) significantly improved central macular thickness and visual acuity in persistent uveitic macular edema.

The authors reviewed the charts of 27 consecutive patients with quiescent noninfectious intermediate or posterior uveitis and cystoid macular edema (CME) treated with the dexamethasone 7 mg implant.

All eyes showed decreased macular edema by one month, although other pathology and complications of uveitis limited visual rehabilitation in some eyes. Mean central macular thickness improved significantly one month after implantation and visual acuity showed significant improvement at three months.

In eyes with longer follow-up (26 of 27 patients followed for a mean of 14.5 months), 23 eyes (85.1%) needed repeat injections for recurrent CME at an average of 4.6 months. Sixteen eyes needed three or more injections. Despite the need for multiple retreatment, the short-term success was excellent.

The authors conclude that the dexamethasone implant may be a useful treatment in the successful management of uveitic CME, even in the absence of active inflammation. They say it may be particularly useful in the treatment of persistent, chronic uveitic CME that has failed multiple treatment modalities and may allow patients to delay more invasive treatment, such as pars plana vitrectomy.