This single-center prospective analysis assessed the effects of repeated intravitreal dexamethasone inserts in patients with noninfectious uveitis and cystoid macular edema or vitritis.
Study design
The cohort comprised 109 eyes (76 patients) that received 3 or more 700-mg Ozurdex implants in 5 years. The cause of uveitis was described as idiopathic, sarcoidosis, Birdshot retinochoroidopathy or systemic condition. Follow-up visits were scheduled 1, 3, and 6 months after injection.
Outcomes
After implantation, central retinal thickness (CRT) decreased significantly from 465 mm at baseline to 318, 342 and 388 mm after 1, 3, and 6 months, respectively. Similar trends were seen in eyes receiving a second and third insert. With the fourth, fifth and sixth inserts, CRT reduced significantly after 1 and 3 months, but after 6 months, CRT values were similar to those at baseline.
Vitreous haze and BCVA also improved, but some eyes experienced a moderate transient rise in IOP. Response to treatment varied based on underlying disease and systemic therapy; patients without concomitant systemic treatment showed the greatest benefits.
Limitations
The study was limited by its nonrandomized, uncontrolled design, BCVA testing with Snellen charts and inclusion of patients with severe and advanced disease. The number of participants was limited to 76.
Clinical significance
The repeated long-term administration of Ozurdex inserts, either alone or in combination with other therapies, led to improved CRT, BCVA and vitreous haze in patients with noninfectious uveitis. Ocular complications were reversible and were managed by local treatment, with exception of cataract formation.